Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Rem
WFA Digital Insight
The demand for skilled health plan provider contracts directors has surged in recent years, with the shift towards value-based care models driving the need for experts who can navigate complex negotiations and strategy development. With the healthcare industry experiencing a significant transformation, professionals with a strong background in network contracting and provider relations are in high demand. Molina Healthcare, a leading healthcare organization, is seeking a Director of Health Plan Provider Contracts to lead their team in developing and implementing innovative contracting strategies. As the healthcare landscape continues to evolve, this role offers a unique opportunity for a seasoned professional to make a meaningful impact. Candidates should be prepared to showcase their expertise in contract negotiations, network development, and team leadership.
Job Description
About the Role
The Director of Health Plan Provider Contracts is a critical role at Molina Healthcare, responsible for leading the team that develops and implements provider network contracting strategies. This role entails day-to-day management of the provider contracting function, including negotiations with complex provider groups, development of standardized contracts, and collaboration with senior leadership to drive business growth. The successful candidate will have a strong background in network contracting, excellent negotiation skills, and the ability to lead a team of professionals.The Director of Health Plan Provider Contracts will report to senior leadership and will be responsible for driving the development of innovative contracting strategies that support Molina Healthcare's business objectives. This role requires a deep understanding of the healthcare industry, including value-based care models, alternative payment models, and regulatory requirements.
The ideal candidate will have a strong track record of success in network contracting, with experience in developing and implementing complex contracts, leading cross-functional teams, and driving business growth through strategic partnerships.
What You Will Do
- Lead the development and implementation of provider network contracting strategies that support business growth and drive value for Molina Healthcare
- Negotiate complex contracts with large-scale provider groups, including alternative payment models and value-based payment contracts
- Develop and maintain standardized contract templates and reimbursement models that support business objectives
- Collaborate with senior leadership to drive business growth and develop innovative contracting strategies
- Lead a team of professionals responsible for provider contracting, including hiring, training, and performance management
- Develop and implement initiatives to drive cost savings and improve network adequacy
- Manage and report on network adequacy for Medicare, Marketplace, and Medicaid services
- Develop and maintain relationships with key stakeholders, including providers, hospitals, and community partners
- Stay up-to-date with industry trends and regulatory requirements, including value-based care models and alternative payment models
What We Are Looking For
- At least 8 years of experience in network contracting, with a focus on large-scale provider groups and complex contract negotiations
- At least 5 years of experience in provider contract negotiations in a managed healthcare setting
- Strong knowledge of value-based care models, alternative payment models, and regulatory requirements
- Excellent negotiation and leadership skills, with the ability to lead cross-functional teams and drive business growth
- Strong analytical and problem-solving skills, with the ability to develop and implement innovative contracting strategies
- Experience with contract management systems and reimbursement models
- Strong communication and interpersonal skills, with the ability to build and maintain relationships with key stakeholders
Nice to Have
- Experience with value-based payment models and alternative payment models
- Knowledge of healthcare policy and regulatory requirements, including NCQA and HEDIS initiatives
- Experience with contract negotiation and management systems
- Certification in healthcare management or a related field
Benefits and Perks
- Competitive salary and bonus structure
- Comprehensive benefits package, including medical, dental, and vision coverage
- 401(k) matching and retirement savings plan
- Paid time off and holidays
- Remote work options and flexible work arrangements
- Professional development and continuing education opportunities
- Recognition and reward programs for outstanding performance
How to Stand Out
- Be prepared to showcase your expertise in contract negotiations and network development, with specific examples of successful contracts and partnerships
- Highlight your experience with value-based care models and alternative payment models, and your understanding of regulatory requirements
- Emphasize your leadership skills, including your ability to lead cross-functional teams and drive business growth
- Make sure your resume and cover letter are tailored to the role, with a focus on relevant experience and skills
- Be prepared to discuss your approach to contract management and reimbursement models, and your experience with contract negotiation and management systems
- Research Molina Healthcare's business objectives and strategy, and be prepared to discuss how your skills and experience align with the company's goals
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