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Role Description

Leads and directs team responsible for health plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Collaborates with senior leadership and the corporate network management team to develop and implement standardized provider contracts and contracting strategies. Also responsible for negotiating complex contracts that are strategically critical to plan success, including but not limited to:

• Alternative payment models (APMs)
• Value-based payment (VBP) contracts
• Capitated payments for hospitals, independent physician associations (IPAs), and complex behavioral health arrangements

Qualifications

• At least 8 years of experience in network contracting with large specialty or multispecialty provider groups
• At least 5 years experience in provider contract negotiations in a managed health care setting
• At least 3 years of management/leadership experience
• Experience with various managed health care provider compensation methodologies
• Excellent negotiation and relationship building capabilities
• Ability to navigate complex regulatory environments
• Strong data-driven decision-making skills, and analytical abilities
• Strong organizational skills and attention to detail
• Ability to work cross-functionally with internal/external stakeholders
• Ability to manage multiple tasks and deadlines effectively
• Excellent verbal and written communication skills
• Microsoft Office suite and applicable software programs proficiency

Requirements

• Deep experience negotiating alternative payment models (APMs)
• Experience with Medicaid, Medicare, and Marketplace government-sponsored programs
• Expertise with Pricing Models & Methodologies
• Experience with Medical Economics & Contract Language
• Provider recruitment experience - hospitals & physician groups

Benefits

Molina Healthcare offers a competitive benefits and compensation package.

Company Description

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.