Molina Healthcare is a Fortune 500 managed care company with a storied history that dates back to 1980 and the opening of a medical clinic by Dr. C. David Molina. As an employer, M
Principal Strategist, Value-Based Network Contracting
Location
United States
Posted
8 days ago
Salary
$79.6K - $172.5K / year
Seniority
Lead
No structured requirement data.
Job Description
Principal Strategist, Value-Based Network Contracting
Molina Healthcare
Role Description Provides deep strategy and leadership for network contracting activities. Responsible for partnering with health plans/segments to develop contracting strategies for Medicaid, Medicare, and Marketplace lines of business. Leads the provider strategy, while developing and maintaining strong and consistent relationships with health plans and segments. Manages key provider relationships - both through health plan/segment partners as well as directly with key providers - and demonstrates comprehensive knowledge of provider interrelationships and the competitive landscape. Collaboratively participates in the development and management of Molina’s rate approval process and fee schedules. Leverages knowledge of contracting best practices, and industry standards to support financial and business objectives. - Formulates network strategies including new-market entry ideation, unit cost optimization, value-based care (VBC) strategies, and other competitive network delivery solutions that enable growth and unit cost enterprise initiatives. - Collaborates with product strategy, operations, sales, clinical, health plan, and other relevant internal stakeholders to achieve network goals. - Develops provider negotiation strategy documents outlining key upcoming negotiations - includes provider profiles, market and network context, historical and projected financial impacts, quality and performance metrics, and strategic alignment with growth and enterprise goals; strategy documents include proposed contracting terms, internal recommendations, negotiation guardrails, and key levers to drive successful outcomes. - Collaborates with medical economics and actuarial partners to develop detailed provider reimbursement strategies that support enterprise initiatives. - Showcases industry experience and expertise in standard fee schedules and contracting strategies, including a strong understanding of Centers for Medicare and Medicare Services (CMS) reimbursement methodologies and commercial fee-for-service models. - Evaluates top provider performance to guide contracting decisions and shape network strategies effectively. - Collaborates with markets to engage on network goals and ongoing progress; reviews anticipated provider contracts for execution and ongoing provider reimbursement rate approvals, synthesizes impact and provides recommendation for leadership approval or adjustments. - Collaborates with configuration, finance, compliance, contracting, and other teams to ensure contract language and rates meet internal policies and requirements. - Provides support in developing and refining template contract language for both facility and professional agreements - ensuring alignment with organizational standards, regulatory requirements, and strategic contracting goals. - Collaborates with internal stakeholders to recommend appropriate language that enhances contract clarity and operational clarity. - Partners with internal stakeholders to support network adequacy, resolve provider issues, and improve access to care. - Supports annual projects related to network expansion, cost-management and operational efficiency; reports on progress and escalates risks where appropriate. - Leverages benchmarking and competitive intelligence tools to inform network strategies - demonstrating proficiency in transparency data sources for competitive positioning and utilizing Power BI and other analytical tools for data driven decision-making. - Understands VBC models available to leverage in markets. - Contributes to ideation and development of process improvements to essential business activities, including rate approval processes, network expansions, and strategy development. - Represents as a professional subject matter expert (SME) in all interactions with providers and internal stakeholders while driving structure, organization, and shared network goals. Qualifications - At least 8 years network contracting/network strategy experience, or equivalent combination of relevant education and experience. - At least 3 years of management/leadership experience. - Strong understanding of health care industry regulations. - Deep experience with contract management software and negotiation techniques. - Experience leading value-based program (VBP) and contract design, and implementation for Medicaid, Medicare, and/or Marketplace programs. - Experience in a complex health care delivery environment, specifically with government sponsored programs, including risk revenue management, strategy and compliance. - Fee-for-service (FFS), pay-for-performance (P4P) subject matter expertise. - Knowledge of medical economics and financial reporting, and ability to walk stakeholders through complex financial reconciliations. - Ability to influence others, 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, and proven ability to develop internal enterprise relations, and external strategic relationships. - Excellent verbal and written communication skills, including ability to present at an executive level to internal/external stakeholders. - Microsoft Office suite and applicable software program(s) proficiency. Benefits - Molina Healthcare offers a competitive benefits and compensation package. - Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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Role Description Brandtech+ is evolving how data is structured, governed, and utilised across global client accounts. The Measurement Lead plays a key role in shaping how delivery, operational, financial, and performance data are captured, connected, interpreted, and communicated across The Mix. This role is responsible for driving consistency, accuracy, and transparency across reporting and measurement frameworks, ensuring stakeholders have access to reliable, actionable insights that support effective decision-making and demonstrate value to clients. Working closely with global and regional teams across delivery, operations, finance, and strategy, the Measurement Lead will support the development of scalable reporting structures, robust data governance processes, and integrated performance views across projects, people, finance, and operational metrics. 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Industry Vertical Leader, Commercial Strategy - Technology, Media and Telecommunications
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Responsibilities - Partner with senior team members across the firm to identify whitespace and cross-sell opportunities within the vertical and equip Account Teams and MDs with the context to pursue them - Own the commercial agenda for the Consumer vertical, serving as the firm’s sector SME - Build and maintain the vertical’s commercial POV, including market updates, sector analysis and origination-focused thought leadership - Monitor industry trends, market signals and competitive dynamics specific to the Consumer sector and translate them into actionable commercial direction - Produce the vertical’s recurring commercial content on a defined cadence, including market updates, sector POVs and quarterly outlooks - Support business development efforts and proposal creation with sector-specific positioning, insight and supporting analysis - Brief client-facing team members, PLLs and Account Teams ahead of priority meetings and pursuits with relevant sector context - Provide the expertise to maintain a credible external presence in the Consumer sector by developing materials and content to be used for bylined content, conference participation and other public-facing channels - Partner with Marketing to align vertical content, campaigns and external presence with firm go-to-market strategy - Coordinate with peer Industry Vertical Leaders to maintain a consistent commercial POV format and cadence across the CE function - Partner with the VP, Account and VP, Pipeline to ensure sector insight is reflected in account plans and pursuit strategy - Share and manage best practices as well as lead internal trainings where required - Support talent acquisition and firm development efforts - Contribute to creating a high-performing and inclusive culture Qualifications - - Bachelor's degree from a top undergraduate program required - Willing to relocate to or be primarily present in Gurgaon - 10 plus years in the Consumer sector, in commercial strategy, business development, consulting, investment banking or an industry-facing advisory role - Recognized subject matter expertise in Consumer, with a credible origination, investment banking or advisory track record in that sector - Demonstrated track record of producing credible, market-facing commercial content for an external audience - Experience operating within professional services, consulting, investment banking or private equity environments - High attention to detail, responsiveness and a process- and ownership-oriented mindset - Strong project management and prioritization skills, with the ability to manage multiple initiatives simultaneously in a fast-paced environment - Experience within the middle market private equity and advisory ecosystem, preferably serving U.S. clients - Familiarity with Intapp DealCloud, HubSpot or equivalent commercial platforms preferred - Experience producing thought leadership or market commentary published in industry-recognized channels preferred - Superior written and verbal communication, including executive-ready presentation and reporting, with the ability to influence stakeholder and work effectively across technical and non-technical teams - Proven ability to thrive in lean, fast-moving teams - High attention to detail, responsiveness and ownership mindset - Track record of success in high-pressure, client-facing environments #LI-Hybrid We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. 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Head of Commercial Enablement, Commercial Strategy
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Title: Head of Commercial Enablement, Commercial Strategy Location: Gurgaon Type: Commercial Strategy Workplace: hybrid Category: Commercial Enablement (India) Job Description: Gurgaon India – Commercial Enablement (India) / Commercial Strategy / Hybrid Portage Point Partners is a Chicago-headquartered advisory, interim management and investment banking firm focused on serving the middle-market. Backed by New Mountain Capital, the firm has grown at over 30% annually since its founding in 2016 and today operates from ten offices across the United States. The firm delivers integrated financial and operational solutions across Transaction Advisory Services, Transaction Execution Services, Office of the CFO, Valuations, Performance Improvement, Turnaround & Restructuring and Investment Banking. Engagement teams are lean and execution-oriented, working directly with senior stakeholders to navigate complex transitions and transformations. 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By leveraging platforms such as Intapp DealCloud and related business systems, the Commercial Strategy team delivers scalable solutions that improve collaboration, increase operational efficiency and support the firm’s continued expansion. The Head of Commercial Enablement (CE) is a dual-mandate leader – a credentialed industry subject matter expert (SME) who also builds and runs the firm’s Commercial Enablement function. You will drive both firmwide CE strategy and operating model while owning the commercial agenda for your respective industry sector. Reporting to the Head of Commercial Strategy, this leader owns one of the firm’s industry verticals while directing the broader CE operating model that spans all verticals, the account and pipeline disciplines and Commercial Operations. As an SME, this leader carries the same sector mandate as the firm’s Industry Vertical Leaders – building the commercial point of view (POV) for an assigned industry, producing the market insight that drives origination, supporting business development efforts and proposal creation. As the function head, this leader sets the CE operating model, manages the Vertical Leaders and the Account and Pipeline Vice Presidents (VPs) and serves as the senior CE voice to the Managing Director (MD) and leadership team. Success is measured by the commercial output of the assigned vertical, the maturity and consistency of the CE operating model across all verticals and the degree to which key stakeholders rely on CE for industry expertise (content and context) and as the engine for origination and pipeline discipline. Responsibilities - Partner with senior team members and Account Teams to convert sector insight into qualified business opportunities - Own the CE operating model – structure, roles, service levels, and cross-functional interfaces – translating firm commercial priorities into a coherent agenda and sequencing function build-out, technology enablement, and team scaling" - Manage and develop the Industry Vertical Leaders and the Account and Pipeline VPs, setting performance standards and accountability mechanisms - Serve as the senior CE representative to executive leadership, Delivery Excellence, Marketing and Practice Line Leaders (PLLs) - Measure and report CE function performance, including vertical output, account and pipeline discipline and Commercial Operations service levels; surface risks and remediation plans to firm leadership - Own the commercial agenda for an assigned industry vertical, serving as the firm’s SME for that sector - Build and maintain the vertical’s commercial POV, including market updates, sector analysis and origination-focused thought leadership - Identify whitespace, market signals and cross-sell opportunities specific to the assigned industry and translate them into actionable commercial direction - Partner with Marketing to align vertical content and campaign targeting with go-to-market strategy - Coordinate with the Product Manager for Intapp DealCloud and the Director of Digital Marketing to ensure CE workflows are supported by reliable systems and data - Align with Delivery Excellence and Operations to ensure the CE model reinforces firmwide commercial discipline - Support business development efforts while maintaining strong relationships with existing clients - Share and manage best practices as well as lead internal trainings where required - Support talent acquisition and firm development efforts - Contribute to creating a high-performing and inclusive culture Qualifications - Bachelor's degree from a top undergraduate program required - Willing to relocate to or be primarily present in Gurgaon - 15 plus years in commercial strategy, business development, consulting or a related industry-facing discipline - Recognized subject matter expertise in a relevant industry vertical (Industrials, Business Services, TMT, Healthcare or Consumer), with a credible origination or advisory track record in that sector - Demonstrated experience building and leading teams, including managing senior individual contributors - Experience operating within professional services, consulting, investment banking or private equity environments - Strong project management and prioritization skills, with the ability to manage multiple initiatives simultaneously in a fast-paced environment - Experience within the middle market private equity and advisory ecosystem, preferably serving U.S. clients - Familiarity with Intapp DealCloud, HubSpot or equivalent commercial platforms preferred - Experience standing up a new function or operating model from inception preferred - Superior written and verbal communication and stakeholder management skills, including executive-ready presentation and reporting, with the ability to work effectively across technical and non-technical teams - Proven ability to thrive in lean, fast-moving teams - High attention to detail, responsiveness and ownership mindset - Track record of success in high-pressure, client-facing environments #LI-Hybrid We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

