You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
- Owns and manages the relationship and performance of key provider groups.
- Influences provider behaviors to drive improvements in provider & member satisfaction, optimizing member outcomes and maximizing shared savings.
- Drives improvement of provider performance by analyzing, interpreting and communicating financial, utilization and quality metrics.
- Establishes and leads cross-functional communication and collaboration with internal departments to support provider performance and resolve barriers and challenges.
- Serves as a primary liaison to providers on claim related content working with other departments for resolution.
- Responsible for understanding the differences between Risk and Value-Based contracting and driving improved provider performance.
- Plans, prepares, and executes effective group meetings/discussions with proper objectives and outcome.
- Responsible for understanding unique contract, quality, network requirements of Medicaid and Medicare.
- Responsible for understanding HEDIS and STARS measures and partner the Quality team to drive improved provider performance.
- Special projects as assigned or directed.
- Performs other duties as assigned
- Complies with all policies and standards
Required A Bachelor's Degree in Health Care, Business, Finance or any other field:
Required or equivalent work experience in Network Management/Network Development, Provider Relations, Risk and /or Value Base Contracting:
Required 5+ years of experience in Network Management/Network Development, Provider Relations, Risk and/or Value Base Contracting, managed care organization: Required 2+ years of experience in Account Management or management experience
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.