Job Details

AVP, Network Market Engagement

The AVP, Network Market Engagement is responsible for contributing to the strategic planning and performance improvement direction for assigned markets. This role serves as a thought leader and strategic partner, aligning local market needs with national best practices to develop and implement programs that reflect leading-edge thinking and deliver measurable value. Acting as the single point of contact for Network functions, the AVP oversees performance and execution to achieve best-in-class outcomes. As a subject-matter expert, this role works closely with provider and medical economics partners to model the expected effectiveness and value of innovative payment, utilization, and cost-of-care initiatives. The position plays a critical role in network market engagement and supports provider payment innovation efforts as part of Molina's Network Center of Excellence across Medicaid, Medicare, and Marketplace lines of business. This role also oversees the implementation of Network Center of Excellence best-practice protocols and processes to ensure consistent, effective operations and optimal results. Experience with Medicaid programs is strongly preferred.

Job Duties

• In collaboration with Health Plan network leadership, supports network team improvement plans based on identified problem areas, potential solutions and barrier removal.
• Subject matter expert for network across all lines of business.
• Consults with MHI Network leaders, national and health plan leadership to facilitate understanding of all program requirements that are critical to performance in the assigned markets and provide those insights during the strategic planning process.
• Acting as a thought leader/partner to support development of a strategic roadmap to achieve best in class performance.
• Knowledgeable of all available best practices and how and when to consider inclusion into the business plan in addition to supporting the business case development with the health plan.
• Support coordination with other lines of business plans.
• Bridge to execution team to support issue resolution, barrier removal to local execution and bring visibility to Network barriers as identified.
• Responsible for management and development of materials and analysis supporting ongoing communications with the health plan.
• Communicates with national and health plan Senior Leadership Teams, including national and health plan Network leadership and other team members about key deliverables, timelines, barriers, and escalation that need immediate attention.
• Translates strategic direction from Network senior leaders into market level business plans inclusive of local initiatives and solicits alignment and signoff of final plan design.
• Presents concise summaries, key takeaways and action steps about functional area to national and health plan meetings.
• Demonstrates ability to lead or influence a cross-functional teams with staff in remote or in-office locations throughout the country.

Job Qualifications

REQUIRED EDUCATION: Bachelor's Degree in a related field (Healthcare Administration, Public Health or equivalent experience)

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

• Minimum 10 years of experience in Managed Care environment.
• Provider network contracting and management experience
• Strong ability to build relationships, translate data into actions and influence others to adopt best practices
• Excellent communication skills across all levels of leadership
• Ability to engage in multiple large-scale projects simultaneously with attention to detail

PREFERRED EDUCATION: Master's Degree in a related field