VP Health Plan Provider Network Strategy & Growth

Molina Talent Acquisition; United States; On-site; USD 180,000 - 280,000; Full time

Job summary

Molina Healthcare in Nevada seeks a VP HealthPlan Provider Network to provide executive leadership for contract strategy and network development. The role requires shaping provider networks, negotiating complex agreements, and aligning with national teams to meet cost and quality goals.

You will lead provider contracting and service strategies to improve access, performance, and satisfaction while ensuring regulatory adherence and cross-functional collaboration with Market, Quality, and

Qualifications

• At least 12 years in health care with provider network management/contracting.
• 10+ years senior network leadership experience or equivalent.
• Deep experience with Medicaid, Medicare, and Marketplace managed care plans is preferred.
• Strong negotiation and relationship-building abilities.

Responsibilities

• Develops and implements provider network and contract strategies, including evaluation of existing networks and expansion into new markets.
• Supports national network and actuarial teams to inform PADU reimbursement guidelines and exception analysis.
• Drives expansion of value-based contracting, including stars, quality, population health, and other metrics.
• Leads network strategy and provides parameters for risk-sharing contracts and performance incentive models.
• Oversees delegation oversight, provider services, and provider/member problem prevention, including appeals and grievances.

Skills

Negotiation

Leadership

Strategic thinking

Cross-functional collaboration

Data analysis

Regulatory navigation

Communication

Contracting

Project management

Executive communication

Tools

Microsoft Office

Job description

Molina Healthcare in Nevada seeks a VP HealthPlan Provider Network to provide executive leadership for contract strategy and network development. The role requires shaping provider networks, negotiating complex agreements, and aligning with national teams to meet cost and quality goals.

You will lead provider contracting and service strategies to improve access, performance, and satisfaction while ensuring regulatory adherence and cross-functional collaboration with Market, Quality, and