VP, Valued Based Contracting (Remote)

Job Summary

The VP Value-Based Contracting is an executive focused on establishing and overseeing the organization’s Value-Based Contracting Center of Excellence.  The position acts as a strategic partner with Network, Medical Economics, Risk Adjustment and Quality, Finance, EIM/IT, and Clinical leadership to develop and implement consistent governance and processes around all aspects of Value Based Contracting.   The scope includes negotiation, valuation, implementation, reconciliation, and the underlying data integrity for value-based contracts.

Job Duties

• Define and implement a Value Based Contracting governance process for the organization.
• Assess internal and external risks associated with VBC, including risks related to state regulations, new / renewal RFPs, data infrastructures, internal silos/processes, etc.
• Define, propose, and align numerous disparate stakeholders around a strategic unified VBC operating model that mitigates risks while enabling strategic differentiators.
• Create standards regarding VBC, including PADUs, analytics, data, and reconciliation processes with providers.
• Ensure alignment with key stakeholders – Network (strategy and negotiation), Med Econ (valuation and reconciliation), Enterprise Information Management (data), Actuarial (review / validation), Finance (review / validation), Risk Adjustment, and Quality.
• Implement and execute the defined enterprise-wide operating model.
• Provide monthly reporting to the organization about all aspects of Value Based Contracting to all levels of leadership at the company, from ELT to Health Plan leadership.
• Define, develop, and recruit talent as needed for the VBC organization to ensure talent at all levels is in place to execute key goals.
• Define and maintain a strong working partnership with Medical Economics, Network, Actuary, Finance, Enterprise Information Management, and IT to determine and implement the best processes, systems, and technology to optimize VBC’s efficiency and effectiveness.
• Provide strategic leadership while also managing multiple, complex, challenging projects and managing extended teams of direct/indirect reports in a matrixed environment.

Job Qualifications

Required Education:

• Bachelor’s degree in business, finance, or economics.

Required Experience:

• 15+ years of leadership experience
• 10+ years experience in value based / network contracting
• Significant experience in health insurance
• Experience leading and influencing both direct and indirect reports

Preferred Qualifications:

• MBA/Masters in applicable field
• PMP or Six Sigma Green Belt Certification desired.

Travel Requirements:

Air Travel:  15%

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.