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.