Education: Bachelor's degree or related field
Experience: 10+ years
Position Purpose: Direct the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department.
Establish the department's strategic vision, objectives, and policies and procedures. Develop, implement and maintain production and quality standards for the Contracting department. Oversee network development staff and external consultants in the development of provider networks across expansion markets.
Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals. Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations. Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy. Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
Assist health plan CEO and/or COO vendors in key provider relations and strategy. Ability to travel. Education/Experience: Bachelor's Degree or equivalent experience in Business Administration, Healthcare Administration or related field required.
MBA or MHA degree preferred. 10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment required. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Pay Range: $180,400.00 - $343,300.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.
Total compensation may also include additional forms of incentives.
Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Thanks for your interest in Centene and its subsidiary companies. We're so glad that you've decided to fill out an application and take the next step to find your purpose.
Also, we're here to help support you on your candidate journey. Should you need an accommodation, please email recruiting@centene.com. Centene is committed to helping people live healthier lives.
We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.
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