Provider Contracts Manager - Complex (Behavioral Health)
Molina Healthcare · Bothell, Washington, US
***Remote and must live in or be willing to travel to Washington*** JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for health p...
Job description
***Remote and must live in or be willing to travel to Washington*** JOB DESCRIPTION: Job Summary: Provides subject matter expertise and leadership for health plan provider network complex contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Responsible for negotiating agreements, including value-based payment methodology, with complex provider groups that are strategically critical to plan success, including but not limited to: hospitals, independent physician associations (IPAs), and behavioral health organizations. Essential Job Duties: - Negotiates contracts and letters of agreement with the complex provider community to secure high quality, cost-effective and marketable plan providers. - Contracts/re-contracts with large-scale entities involving custom reimbursement; executes standardized alternative payment model (APM) contracts; issues escalations, and supports network adequacy, joint operating committees (JOCs), and delegation oversight. - Execution, management, and optimization of value-based contracts and enhanced provider relationship management. - Directs analysis of financial impac...