Contract
Director Value-Based Programs
Value-Based Contracting, CMS LAN
Updated on 9/4/2026
Molina Healthcare
10,001+ employees
Administers government-sponsored Medicaid, Medicare plans
Compensation Overview
$97.3k - $189.7k/yr
Orlando, FL, USA + 5 more
More locations: Tampa, FL, USA | Miami, FL, USA | Florida, USA | Jacksonville, FL, USA | St. Petersburg, FL, USA
Remote
 Business & Strategy (1) |
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- At least 8 years of managed care experience, including value-based programs experience, or an equivalent combination of relevant education and experience.
- At least 3 years of management or leadership experience.
- Experience leading value-based program 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.
- Knowledge of value-based programs, risk adjustment models, quality metrics such as Healthcare Effectiveness Data and Information Set and Medicare STARS, and coding.
- Knowledge of medical economics and financial reporting, with the ability to walk stakeholders through complex financial reconciliations.
- Leadership skills, including the ability to influence others outside a direct reporting line, think strategically, develop a vision, and execute effectively and efficiently for 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, with the ability to develop internal enterprise relations and external strategic relationships.
- Excellent verbal and written communication skills, including the ability to present at an executive level to internal and external stakeholders.
- Proficiency with the Microsoft Office suite and applicable software programs.
- Lead and direct the team responsible for value-based program activities.
- Develop and implement value-based strategies for lines of business affected by the regulatory risk-adjustment payment model.
- Design and implement strategies to improve existing value-based initiatives and lead innovation to identify initiatives that improve accuracy, compliance, and completeness in risk-adjustment revenue for government lines of business.
- Support the strategic direction and corporate initiatives that facilitate value-based financial strategy and business objectives.
- Own the development and execution of the annual value-based programs and contracts plan by state and line of business.
- Identify providers for potential value-based care contracts; assist network teams with outreach; develop suggested contract terms, including financial and quality metrics, benchmarks, and reporting responsibilities; set annual program and contract targets; and develop recurring provider reports to support goal achievement.
- Collaborate with risk-adjustment leadership to use needs assessments to guide contracting and program strategy.
- Design and maintain an internal dashboard of value-based programs and contracts by state and line of business for monitoring, measurement, comparisons, progress tracking, and financial forecasts.
- Support the launch of value-based programs in new markets and expansion of existing markets to achieve requests-for-proposals goals and financial forecasts.
- Present value-based program, contract, and reimbursement performance to senior leadership in monthly and quarterly meetings, and design an oversight process for monitoring existing contracts.
- Ensure value-based contracting and reporting data are accurate internally and externally.
- Hire, train, manage, and evaluate team-member performance; provide coaching, development, and recognition; ensure appropriate ongoing staff training; hold regular team meetings; and drive communication and collaboration.
- Develop and sustain a high-performance team responsible for attracting, developing, and retaining talent in support of strategy and long-term business objectives.
Molina Healthcare provides government-sponsored health plans in the United States, primarily serving low-income individuals and families through Medicaid, Medicare, and Marketplace products. It partners with state and federal governments to administer these programs and earns revenue from member premiums and payments for program management. A key differentiator is its focus on cost management and preventive care, aided by an online provider portal that lets clinicians verify eligibility, submit claims, and access resources. Its goal is to expand access to affordable, quality health coverage while delivering sustainable administration of government-backed plans.
Company Size
10,001+
Company Stage
IPO
Headquarters
Long Beach, California
Founded
1980
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Simplify's Take
What believers are saying
- Second-quarter 2026 adjusted EPS hit $1.51, and management raised guidance to $5.25.
- Medicaid stabilized at a 92.7% medical care ratio, supporting 2026 margin recovery.
- Molina’s 2027 MAPD exit removes a $1 billion distraction and refocuses capital.
What critics are saying
- The July 2026 lawsuit alleges Molina misled investors on medical-cost forecasts through February 2026.
- Marketplace losses cut 2026 EPS by $1.50, and management plans $1 billion less exposure.
- April 2026 Long Beach layoffs and ongoing contract exits signal execution strain and churn.
What makes Molina Healthcare unique
- Molina dominates Medicaid and duals, targeting low-income populations across 21 states.
- Its 2026 pivot exits MAPD, sharpening focus on higher-value Medicare-Medicaid products.
- State contract execution remains core, with Florida Medicaid and marketplace retrenchment reshaping mix.
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Benefits
Health Insurance
401(k) Retirement Plan
Remote Work Options
Paid Vacation
Flexible Work Hours
Wellness Program
Mental Health Support
Conference Attendance Budget
Professional Development Budget
Phone/Internet Stipend
Home Office Stipend
Family Planning Benefits
Fertility Treatment Support
Stock Options
Company Equity
Hybrid Work Options
PTO/vacation mention not explicit beyond Paid Vacation
Paid Sick Leave
Paid Holidays
Adoption Assistance
Company News
Dentsply Sirona and Novavax face significant operational challenges, while Molina Healthcare shows more promise, according to a recent stock analysis. Healthcare stocks have returned 25.1% over the past six months, outperforming the S&P 500 by 13.1 percentage points. Dentsply Sirona, which manufactures dental equipment, has seen earnings per share drop 13.6% annually over five years. Its negative returns on capital suggest management is losing money whilst attempting to expand the business. Novavax, a vaccine developer, has experienced revenue declining 18.9% annually over the last five years. The company's adjusted operating margin fell 26.9 percentage points over two years as it struggled to adjust its cost structure. Both companies face regulatory pressures typical of the healthcare sector, which can significantly influence their earnings potential.
Corient Private Wealth LP acquired a new stake in Molina Healthcare, Inc (NYSE:MOH – Free Report) in the 2nd quarter, according to the company in its most recent Form 13F filing with the Securities and Exchange Commission. The fund acquired 11,823 shares of the company’s stock, valued at approximately $2,704,000. A number of other hedge […]
Press release: The Molina Healthcare Charitable Foundation grants $25,000 to the Missouri Rural Health Association to support Rural Health leadership and mentorship program. On: August 27, 2026 The Molina Healthcare Charitable Foundation ("MolinaCares"), in collaboration with Molina Healthcare of Missouri ("Molina"), has awarded a $25,000 grant to the Missouri Rural Health Association ("MRHA") to launch the Causeway Lighthouse, a mentorship initiative connecting rural health leaders across the state. The program extends MRHA's "Causeway," a free, virtual community offering resources, case consultations, and legislative tracking. Missouri's rural communities face significant healthcare workforce challenges, with over 78% of the state's Health Professional Shortage Areas in rural areas. A 2024 MRHA assessment of healthcare professionals found widespread professional isolation, limited access to reliable resources, and gaps in communication training, along with strong interest in a shared peer network. The Causeway Lighthouse responds directly to these findings, pairing rural health leaders through structured mentorship and peer support. "Rural health leaders do their best work when they have peers to learn from and a structure to support their growth," said Heidi Lucas, executive director, Missouri Rural Health Association. "Molina's grant allows the rural health workforce a place inside the Causeway where established leaders mentor emerging ones through direct listening, hands-on onboarding, and ongoing peer support." The Causeway Lighthouse will operate as a centralized, virtual hub where rural health leaders connect for peer-to-peer mentorship and collaborative problem-solving. The MolinaCares grant funds recruitment and onboarding of emerging and established rural health leaders, one-on-one listening sessions, and mentor preparation. "Consistent mentorship and peer support strengthens the healthcare workforce, thereby improving the continuum of care," said Jay Ludlam, plan president, Molina Healthcare of Missouri. "By supporting MRHA's Causeway Lighthouse, we are creating a practical forum for leaders where the sharing of knowledge and shared challenges results in healthier outcomes for Missouri's rural communities." Interviews are underway to identify mentors for the Causeway Lighthouse community. The initiative is expected to launch in December 2026. The grant is part of Molina's Advancing Health: Powered by Local Partnerships initiative, which invests in community-based organizations that remove barriers to care and improve health outcomes.
Two healthcare companies with strong cash positions are attracting investor attention, whilst a fertility benefits provider faces challenges. Progyny holds $214.4 million in net cash, representing 14.2% of its market capitalisation. However, the company has struggled with underwhelming unit sales over the past two years and demonstrates below-average returns on capital. Trading at $27.95 per share, Progyny commands a 13.9x forward price-to-earnings ratio. Molina Healthcare maintains a net cash position of $1.22 billion, or 11.9% of market cap. The managed healthcare provider has achieved 13.7% annual revenue growth over five years, outpacing sector averages. Operating across 21 states, Molina serves low-income individuals through Medicaid, Medicare, and Marketplace programmes. Axos Financial, a digital banking and financial services company, holds $39.48 million in net cash, though this represents just 0.7% of its market capitalisation.
Kentucky kindergarten vaccination rates among lowest in nation. Posted: Aug 5, 2026 / 03:16 PM CDT Updated: Aug 5, 2026 / 03:16 PM CDT * Kentucky ranked fifth lowest nationally for kindergarten vaccination rates during the previous school year. * Measles cases nationwide reached a 35-year high throughout the first seven months of 2026. * Community organizations offered free medical services and supplies to help families prepare for school. KENTUCKY (FOX 56) - As Kentucky students return to classrooms, health officials are raising concerns about the state's kindergarten vaccination rates, which rank among the lowest in the nation. According to the Centers for Disease Control and Prevention's SchoolVaxView survey, Kentucky ranked fifth lowest in the country for kindergarten vaccination rates during the last school year. About 86% of Kentucky kindergarteners were up to date on required vaccines, compared with the national average of 91%. Dr. Stanton said maintaining high vaccination rates is important not only for individual students but for the broader community. "There are a lot of things that were very bad a century ago that we have gotten rid of, or almost completely eradicated, because of vaccinations," Stanton said. "As a health care professional, we don't want to see a return to these times where there's such high risk on things we can prevent." Health experts say vaccinations help protect people who cannot receive vaccines or who may not develop a strong immune response after vaccination. "Herd immunity is incredibly important because some people simply can't get the vaccinations and others don't respond or don't build an appropriate immune response to that vaccination," Dr. Stanton said. "So we're protecting them." Latest KENTUCKY news: He says herd immunity is also important when it comes to measles, given how contagious the virus is. He says 96% vaccination rates are needed for herd immunity. "We're already seeing a 35-year high in measles cases across this country in 2026 through the end of July had already seen as many cases as all of 2025, and those numbers are going to continue to grow," Dr. Stanton said. To help families prepare for the school year, organizations are providing resources before classes begin. Passport by Molina Healthcare hosted a back-to-school event at its One Stop Help Center in Lexington, offering families free physicals, vaccinations and dental care through a partnership with Kare. The event also provided backpacks and new shoes donated by community organizations. "It is important because we want our kids to be in the best shape to start school," said Mendez. "So vaccines, dental and medical care are an important part of getting ready for school." Despite the benefits of vaccination, Dr. Stanton said misinformation continues to contribute to vaccine hesitancy among some parents. One common concern he hears is that natural immunity is stronger than immunity from vaccines. Dr. Stanton said vaccines protect while avoiding the risks associated with contracting preventable diseases. "The challenge we're facing right now is just this simple distrust," Stanton said. "It was already existing, but it was fueled significantly by the COVID pandemic." As families complete their back-to-school preparations, Stanton encourages parents to rely on medical professionals and evidence-based sources when making health decisions. "I would strongly encourage you to talk to a pediatrician or use legitimate evidence-based sources and have those conversations, because when you make these decisions, you're making the decision for a child or a newborn that can't make decisions on their own," said Dr. Stanton.