Health Plan Provider Contracts Manager (Contract Experience Required)
Molina Healthcare
Hospitals, Clinics, Non-Medical Staff
Ridgeland, MS - USA
Senior Specialist / Project Manager
Experteer Overview
In this role you will lead health plan provider network contracting, shaping agreements with hospitals, IPAs, and behavioral health groups. You will drive value-based arrangements, ensure network adequacy, and optimize financial performance. You’ll partner with contracting leadership to negotiate complex terms and support network strategy aligned with Molina’s mission. You will influence reimbursement models, provide guidance to teams, and work across regions to meet network standards. This is a high-impact role at Molina focused on scalable, market-leading provider contracts.
Compensation / Benefits
- competitive benefits and compensation package
Responsibilities
- Negotiate contracts with complex provider groups to secure high-quality, cost-effective network providers
- Manage large-scale contracts with custom reimbursement and standard APM contracts; support JOCs and delegation oversight
- Execute and optimize value-based contracts and provider relationships
- Analyze financial impact of deal terms and prepare justification for executive approvals beyond standard guidelines
- Negotiate PADU-guided high-priority physician/hospital contracts with emphasis on value-based participation
- Maintain and update provider contracts in contract management software
- Target and recruit providers to improve member access and reduce grievances
- Advise contracting team on individual and routine ancillary contracts
- Maintain relationships with significant providers
- Assess contract language for regulatory and corporate standards; coordinate with corporate attorney
- Contribute to fee schedule determinations and input on new reimbursement models
- Educate internal customers on provider contracts and clearly communicate terms
- Participate in leadership and cross-functional committees toward departmental goals
- Contribute to contracting-related special projects and provide training to staff
- Travel across designated regions to meet needs
Key requirements
- 5+ years in network contracting with large multispecialty provider groups
- 3+ years in provider contract negotiations in managed care; multiple contract types preferred
- Familiarity with Medicaid/Medicare value-based payment, FFS, capitation, and risk models
- Strong negotiation and relationship-building capabilities
- Ability to navigate complex regulatory environments
- Data-driven decision-making and analytical skills
- Strong organizational skills and attention to detail
- Ability to work cross-functionally in a matrixed organization
- Effective verbal and written communication
- Proficiency with Microsoft Office and applicable software
Description
In this role you will lead health plan provider network contracting, shaping agreements with hospitals, IPAs, and behavioral health groups. …
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