Senior Specialist, Provider Contracts HP

Job Summary Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. Job Duties This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. u2022 Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. u2022 Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. u2022 Supports VBC network throughout the state to include onboarding VBC providers and supporting JOCu2019s. u2022 Clearly and professionally communicates VBC contract terms to VBC providers. u2022 Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. u2022 Communicates proactively with other departments to ensure effective and efficient business results. u2022 Trains and monitors newly hired Contract Specialist(s). u2022 Participates in other VBC related special projects as directed. u2022 Limited team travel once to twice annually. Job Qualifications REQUIRED EDUCATION: Bacheloru2019s Degree or equivalent work experience in health care field including, but not limited to, provideru2019s office, managed care, or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: u2022 4-6 yearsu2019 previous experience in contracting with large specialty or multispecialty provider groups. u2022 1-3 Years Managed Care experience PREFERRED EXPERIENCE : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2025-12-05