AVP, Value Based Payment & Execution (Remote in Georgia)

Job Summary

This AVP role reports to the Georgia Health Plan and requires residence Georgia.

The Assistant Vice President (AVP) Value Based Payment & Execution for Molina Healthplays a critical role in the development and implementation of business strategies, operations and vendor management related to activities in all government lines of business.  Accountable for designing and implementing a strategy to continuously improve results of existing initiatives while also leading a continuous process of innovation to identify new initiatives which lead to the overall improvement of population health management, reduction of clinical care gaps, increased member and provider satisfaction, and efficiently managed medical costs. 

Leads strategy, implementations and ongoing support of Value Based Programs and contracts through reporting, reconciliations and all aspect of ROI realization.  The scope includes evaluation and implementation of IT and analytics tools to support current and new value based programs.  Lead identification of target providers and payment innovation models for VBP, creates models for provider negotiations and supports ongoing reporting and support of the programs/contracts.  Monitors the industry for new best-in-class value based and payment innovation models and tools. 

Knowledge/Skills/Abilities

• Leverages deep understanding of VBP across multiple lines of business and with a deep understanding of the Georgia market to develop innovative ideas, evaluate ideas for ROI, design relevant pilots to test ideas and scale successful pilots across relevant lines of business and provider types.
• Utilize extensive knowledge of Value Based Contracting models in managed care and payment innovation concepts to drive value across all Molina Value Based Programs and Contracts across all Lines of Business.
• Evaluate potential and support vendor alignment for applicable value based program services within Georgia for all lines of business.  Requires knowledge of market IT tools and capabilities of competitors to leverage IT tools to drive ROI.
• Oversees and drives health plan key performance indicators such as revenue optimization, market growth, and medical cost management in partnership with key stakeholders 
• Supports provider engagement department with physician education/engagement, value-based payment programs and/or provider performance programs.
• Monitors competitive landscape and industry best practices to ensure Molina leverages best in class analytic and reporting capabilities for value based program support.
• Develops and sustains a high-performance team, dedicated to best in class solutions, responsible for attracting, developing and retaining top-tier talent to support strategy and long-term business objectives.
• Ensures performance targets are set, clearly communicated, implemented, assessed and completed for overall team performance and adherence.
• Interacts and supports regulatory agency policy and procedures by acting as a key business partner to Network CoE Leadership, Georgia P&L leaders, health plan product design, and actuary and finance.
• 10+ years managed care experience, with 7+ years with leadership-level experience preferably with a national or multi-location organization.
• Experience with VBP models for marketplace, Medicaid and/or Medicare.
• Knowledge and 7+ years experience negotiating and/or supporting complex value based contracts between payors and providers in a Medicaid or Medicare environment.
• Experience in a complex healthcare delivery environment, specifically with government sponsored programs, VBP strategy and compliancy.
• Possess a proven track record of leading & developing high performance teams, with developing strategies for new product/service offerings, provider engagement and value-based initiatives and/or population management engagement.
• Excellent leadership skills 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 drive large organizational change.
• Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relations, and external strategic relationships.
• Excellent presentation and communication skills.

Job Qualifications

REQUIRED EDUCATION:

Minimum Bachelor’s Degree in Public Health, Business, Finance or equivalent combination of education and experience.

PREFERRED EDUCATION:

Master’s Degree in a related field (Healthcare Management, Business Administration, etc.)

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

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.

#PJCorp

Pay Range: $161,914.25 - $315,733 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.