Director, Provider Contracts (Must reside in Georgia)

Job Summary

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Plans, organizes, staffs, and coordinates the Provider Contracts activities for the state health plan. Works with direct management, senior leadership / management, Corporate, and staff to develop and implement standardized provider contracts and contracting strategies.

Job Duties

• Manages the Plans Provider Contracting functions and team members.
• Manages and reports network adequacy for Medicare, Marketplace, and Medicaid services.
• In conjunction with direct management and senior leadership, oversees development of provider contracting strategies including VBP.
• Leads the achievement of annual savings through recontracting initiatives.
• Leads the preparation and negotiations of provider contracts and oversee negotiation of contracts, including VBP, in concert with established company guidelines with physicians, hospitals, and other health care providers.
• Utilizes standardized contract templates and VBP / Pay for Performance strategies.
• Develops and maintains Reimbursement Tolerance Parameters (across multiple specialties / geographies).
• Communicates new strategies to corporate provider network leadership for input.
• Participates on the management team and other committees addressing the strategic goals of the department and organization.
• Oversees the maintenance of all Provider Contract templates including VBP program templates.
• Manages the contracting relationships with area agencies and community partners to support and advance Plan initiatives.
• Manages and provides coaching to Network Contracting Staff.
• Manages and evaluates team member performance; provides coaching, consultation, employee development, and recognition; ensures ongoing, appropriate staff training; holds regular team meetings to drive good communication and collaboration; and has responsibility for the selection, orientation and mentoring of new staff.

Job Qualifications

Required Education : Bachelors Degree in a related field (Business Administration, etc.) or equivalent experience.

Required Experience / Knowledge, Skills & Abilities :

Preferred Education : Masters Degree in a related field or an equivalent combination of education and experience

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. Pay Range : $97,299 - $227,679 / ANNUAL