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Job Description

Job Summary

The National Program Director – Value-Based Care is a strategic leadership role responsible for the development, implementation, and evolution of value-based care (VBC) programs across all lines of business—Medicaid, Medicare, and Marketplace. This role is critical in driving clinical and financial performance by aligning provider incentives with quality outcomes, health equity, and cost-effective care. The Director will serve as the enterprise lead for VBC program design, working across diverse provider types including primary care, behavioral health, long-term supports and services (LTSS), hospitals, and community-based organizations.

The ideal candidate is a self-starter with deep expertise in VBC trends, levers of performance, and risk-sharing models. They will partner closely with clinical, actuarial, analytics, network, community engagement, and business development teams to craft tailored, scalable VBC programs that respond to the needs of diverse populations and contribute meaningfully to RFP submissions and growth strategies.

Key Responsibilities

+ Lead the end-to-end design of value-based care programs that are responsive to market needs and tailored for Medicaid, Medicare, and Marketplace populations.

+ Develop contracting frameworks that are inclusive and attractive to a broad array of provider types, including FQHCs, BH providers, LTSS agencies, and hospital systems.

+ Integrate social determinants of health (SDOH) and health equity principles into VBC models to optimize health outcomes for underserved populations.

+ Analyze industry trends, health plan and provider performance data, and regulatory developments to inform innovative and compliant VBC program designs.

+ Serve as the primary architect for the organization’s VBC strategy in all RFP submissions, aligning with business objectives and differentiating the organization in competitive procurements.

+ Collaborate with cross-functional stakeholders to ensure program alignment with clinical models of care, quality strategies, and organizational goals.

+ Establish metrics and monitoring plans to track program performance, and iterate designs based on provider feedback, market dynamics, and population health needs.

+ Act as a subject matter expert and thought leader, representing the organization in external forums, conferences, and stakeholder meetings.

Knowledge/Skills/Abilities

+ Deep understanding of current value-based care trends, performance levers, and innovative payment models (e.g., shared savings, capitation, pay-for-performance).

+ Knowledge of clinical priorities across different population segments and provider types, with ability to design programs that align incentives to desired outcomes.

+ Strong familiarity with SDOH, health equity, and the role of community-based organizations in achieving whole-person care.

+ Excellent stakeholder engagement skills, including the ability to work collaboratively across matrixed teams and influence without direct authority.

+ Data-driven mindset with ability to interpret complex clinical, utilization, and financial data to inform strategy.

+ Experience drafting value-based care narratives for RFPs, with a clear understanding of procurement scoring drivers and competitive positioning.

+ Exceptional written and verbal communication skills, capable of translating complex strategies into actionable frameworks.

+ Comfortable navigating ambiguity, independently driving initiatives forward in a fast-paced, evolving environment.

Required Education

+ Bachelor's Degree in a related field (Health Policy, Public Health, Business Administration, etc.) or equivalent experience

Required Experience

+ 7+ years minimum experience in value-based care design or provider network strategy.

+ Experience across multiple lines of business including Medicaid, Medicare, and Marketplace.

+ Demonstrated success in designing, implementing, or managing value-based care programs with measurable results.

+ Experience working with or within payer organizations, provider groups, or government-sponsored programs.

Preferred Education

Master’s degree in Public Health, Health Administration, Business, or related discipline.

Preferred Experience

+ Experience developing RFP content and/or responding to government procurements.

+ Prior experience with health equity initiatives or SDOH-focused care delivery models.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.

Pay Range: $107,028 - $208,705.4 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.