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.
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