Job Description
Job Description
Job Summary
Provides subject matter expertise for the design and implementation of value-based care programs across Medicaid, Medicare, and Marketplace populations, ensuring alignment with clinical, quality and financial goals.
Job Duties
• Leads the end-to-end design of value-based care programs that are responsive to market needs and tailored for Medicaid, Medicare, and Marketplace populations.
• Develops contracting frameworks that are inclusive and attractive to a broad array of provider types, including Federally Qualified Health Centers, behavioral health providers, Long-Term Services and Support agencies, and hospital systems.
• Integrates social determinants of health and health equity principles into Value-Based Contracting models to optimize health outcomes for underserved populations.
• Analyzes industry trends, health plan and provider performance data, and regulatory developments to inform innovative and compliant value-based contracting designs.
• Serves as the primary architect for the organization's value-based contracting strategy in all RFP submissions, aligning with business objectives and differentiating the organization in competitive procurements.
• Collaborates with cross-functional stakeholders to ensure program alignment with clinical models of care, quality strategies, and organizational goals.
• Establishes metrics and monitoring plans to track program performance, and iterate designs based on provider feedback, market dynamics, and population health needs.
• Acts as a subject matter expert and thought leader, representing the organization in external forums, conferences, and stakeholder meetings.
Job Qualifications
REQUIRED QUALIFICATIONS:
• At least 8 years of experience in Healthcare Administration, Managed Care, and/or Provider Network Management and Operations with an emphasis on value-based care and/or population health.
• Excellent and clear written and verbal communication skills.
• Strong leadership and cross-functional collaboration capabilities.
• Analytical and strategic thinking skills; ability to use data to drive decision-making.
• Proficiency in Microsoft Office Suite.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.