National Network Performance Director

Molina Healthcare•Long Beach, CA

About The Position

Provides subject matter expertise for identifying, developing, and operationalizing scalable cost of care and network performance initiatives across the enterprise. Leads the end-to-end lifecycle from unvetted ideas through discovery and development, including defining payer-provider opportunities and quantifying plausible cost savings.

Requirements

At least 7 years of experience in a Managed Care environment, or equivalent combination of relevant education and experience.
Provider network contracting and management experience.
Critical-thinking, problem-solving and analytical skills.
Ability to process corporate strategy and strategic priorities into a roadmap within assigned network performance areas.
Excellent communication skills across all levels of leadership.
Ability to collaborate across teams in a highly matrixed organization.
Ability to build relationships, translate data into action and drive/influence change and initiatives across the enterprise.

Responsibilities

Generate, curate, and prioritize early-stage ideas for cost and network improvement initiatives, balancing innovation with regulatory, compliance and operational constraints.
Lead structured discovery efforts – including data analysis, stakeholder input, and external benchmarking – to mature unvetted ideas into defined concepts, provider behavior change hypotheses, and credible cost-savings business cases with scorable action items (SAIs).
Partner with analytics, finance, clinical, and other cross-functional teams to ensure business cases and initiatives are credible, defensible, and aligned with enterprise standards.
Identify and monitor industry trends in health care cost, provider reimbursement, and utilization management, with a focus on implications for Medicare, Medicaid, Duals and Marketplace lines of business.
Serve as a bridge between corporate strategy and health plan execution, converting approved initiatives into clear, standardized playbooks that are adaptable to local market variation while preserving enterprise targets.
Present concepts, business cases, and playbooks to senior leadership and executive stakeholders, influencing prioritization, investment decisions, and rollout strategy.
Create and execute enterprise operational plans to deploy initiatives, leading market teams and health plans through execution, monitoring performance against forecasts, and iterating to amplify impact.
Provide end-to-end oversight of internal business projects and programs from initiation through delivery, ensuring adherence to scope, schedule, budget and structured design, analysis, and delivery practices; engage and oversee external vendors as needed.
Proactively identify implementation barriers, compliance considerations, and change management risks; establish and manage a disciplined issue escalation and resolution process to remove roadblocks and maintain momentum.
Support change management, communication planning, and stakeholder readiness to ensure successful adoption and sustained outcomes of delivered solutions.