AVP, Network Strategy & Services - Indiana

AVP, Network Strategy & Services

• Indiana at Molina Healthcare in Caldwell, Idaho, United States Job Description

JOB DESCRIPTION

Job Summary Provides strategy and leadership to team responsible for provider network management, operations, and contracting activities . Leads network strategy and development with respect to adequacy, financial performance, and operational performance. Develops network standards and resources designed to enable Molina to establish and maintain distinct high-performing networks of compassionate and culturally sensitive providers aligned with Molina's mission, vision and values. Essential Job Duties

• Supports strategy development, vision and direction for the network function. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
• Develops and implements provider network and contract strategies in new Molina markets
• identifying specialties and geographic locations to concentrate resources for the purpose of establishing a sufficient network of participating providers to serve the health care needs of Molina's membership and meet established financial goals.
• Develops and maintains a market-specific provider reimbursement strategies consistent with reimbursement tolerance parameters (across multiple specialties/geographies).
• Oversees the development of new reimbursement models; facilitates communication, oversight and approval processes for health plan exceptions for all lines of business. Develops and enhances the provider network management and operations function including the implementation of standard processes, policies and procedures.
• Develops a standardized provider engagement "tool kit", training program and deployment plan.; develops and implements approaches to determining outcomes of tools and training programs.
• Collaborates closely with health plans leadership to ensure compliance with all Molina, regulatory and industry standards.
• Supports and executes new health plan implementations, acquisitions and expansions in collaboration with the business development team.
• Collaborates with senior leadership, health plan leadership, and collaborating functions to develop and implement provider contracting strategies and provider service strategies to contain unit cost, improve member access and enhance provider satisfaction enterprise-wide.
• Develops and oversees deployment strategy and monitoring for "provider profiles" and "pay-for-performance (P4P)" contracting.
• In conjunction with provider services and provider contracting leaders in the he

Job Posting:

JC291894099

Posted On:

May 16, 2026

Updated On:

May 16, 2026