Molina Healthcare · 17 hours ago
Regional Manager, Value-Based Programs - REMOTE
United States
Full-time
Remote
Mid, Senior Level
$80K/yr - $130K/yr
4+ years expMolina Healthcare is a leading organization in the healthcare sector, seeking a Regional Manager for Value-Based Programs. The role involves providing expertise and leadership in developing and implementing value-based programs, managing contracts, and ensuring financial performance aligns with local health plan goals.
Health CareHospitalMedical
Responsibilities
Collaborates directly with assigned market network leaders to identify providers for value-based contracting (VBC)
Supports local network team and national contracting team in identification of relevant metrics and benchmarks for contracting, assists with proposal and counter-proposal preparations, assists with periodic reconciliations and data sharing processes, and supports process for setting annual targets for each value-based arranged in conjunction with national quality and risk adjustment leadership and local health plan resources
Leverages knowledge of local market/line of business and applicable state/federal requirements to ensure workplans for value-based contracting are sufficient to meet requirements
Reviews internal dashboard of value-based programs and contracts by state by line of business for assigned markets each period; ensures data is accurate and any needed modifications are made on a timely basis
Supports launching of value-based programs in new markets/expansion of existing markets to achieve goals in requests for proposals (RFPs) and financial forecasts
Ensures internal/external VBC/reporting data and reporting is accurate; ensures local market finance partners have required information to produce accurate accounting for value-based arrangements
Ensures performance targets are set, clearly communicated, implemented, assessed and completed for overall team performance
Ability to manage multiple priorities and navigate ambiguity in a fast-paced environment
Build and maintain long-term, collaborative relationships with market teams to drive engagement and performance
Qualification
Required
4+ years of managed care experience – Medicaid, Medicare, Marketplace
Experience participating in value-based program & contract design and implementation for marketplace, Medicaid and/or Medicare
Experience in a complex healthcare delivery environment, specifically with government sponsored programs, including risk revenue management, strategy, and compliance
Knowledge of value-based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge of coding
Knowledge of medical economics and financial reporting. Must be able to walk stakeholders (internal and external) through basic financial reconciliations
Exceptional communication, facilitation, and relationship-building skills
Strategic thinker with strong problem-solving and decision-making abilities
Excellent leadership skills, especially the ability to influence others who are not in a direct reporting line including ability to think strategically, develop vision, and execute effectively and efficiently for both near term and long-term results
Proven ability to innovate and manage complex processes across multiple functional areas
Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relations, and external strategic relationships
Excellent presentation and communication skills
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (56)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
2026-01-17
Company data provided by crunchbase