Description
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.
Position Purpose: Lead the development, management, governance and utilization of strategies related to provider performance management, engagement and communication. Lead the team to meet goals for provider education and communication. Drive provider performance to ensure company and department goals are met.
- Analyze and recommend which providers to include in VAB (Value Based Contracting) which includes State required VAB and Centene required VAB
- Analyze and recommend which measures, targets, and weights to assign for VAB (Value Based Contracting) which includes State required VAB and Centene required VAB
- Ensure data integrity by resolving data issues in pay for performance and value based contracting data sources that are provider facing and determine earnings, or financial deficit or surplus
- Drive team performance to align with company and department goals and state contract requirements.
- Drive provider performance and engagement to align with company and department goals.
- Driving consistent processes and approaches for how we engage providers (regardless of provider type), inclusive of standardized templates, tools, documentation, meeting prep and follow-up
- Oversee Provider Performance Management and Remediation reporting, processes, and corrective action
- Support PPG Governance and Scorecard
- Oversee the Division of Responsibilities (DOR) for the Department
- Coordinate with other teams where Roles/Resp related to DOR are incomplete or unknown
- Develop approach and standard tools for documenting Standard Operating Procedures (each leader is responsible for implementing)
- Maintain overall program plan for department projects
Education/Experience: Bachelor’s degree in Health Care Administration, Analytics, Business or related field or equivalent experience. 4+ years of managed care industry experience. 0-3 years of supervisory/management experience. Data Analytics experience preferred.
Candidates must reside in the state of California to be considered for this position. This position allows for mostly remote work, but will require occasional travel to different locations in California.
The hiring team may consider candidates outside of CA if they have significant prior experience working with healthcare providers in California markets.
Pay Range: $103,500.00 - $191,600.00 per yearCentene 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. Total compensation may also include additional forms of incentives.
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