Description
Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Position location: Remote Nationwide
Position Purpose:
Ideate and execute strategies that create business value in Network Development, Operations and Contracting in partnership with key stakeholders. Act as subject-matter expert in Network Contracting solutions, including determining and recommending approaches for developing specialized provider networks, contracting and partnership discussions, quality, and cost performance. Cultivate a high performing team that makes tangible improvements to the Company and its businesses.
- In partnership with LOB leadership, develop and implement provider network and contract strategies identifying those facilities, specialties, other medical services, and geographic locations to serve the health care needs of the members.
- Execute on company network accuracy, adequacy and appointment availability goals and standards
- Ensure that Network capabilities form a cohesive offering by working closely with key stakeholders to learn their needs and define solutions to achieve the business objectives and meet established financial goals.
- Provide strategic input in support of network cost of care improvement opportunities and lead the development and execution of plans to achieve targeted results.
- Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
- Design and implement recruitment plans, negotiate contracts, and coordinate with hospitals, physicians, and ancillary providers.
- Manage a community of all provider network leaders across the company and drive consistency and quality of talent across the health plans despite the market-based network leaders not reporting into national network
- Ensure compliance with regulatory standards and maintain provider data integrity.
- 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 in support of organizational growth. Participate in acquisition and growth activities, as well as divestitures of plan assets, including investigations, evaluations, and negotiations, in accordance with objectives and plans established by the Company.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience:
Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration or related field; MBA or MHA preferred. 12+ years of network development and provider relations/contracting management experience in a health care and/or managed care environment. Strong negotiation and communication skills required.
Pay Range: $350,000.00 - $800,000.00 per year
License/Certificates: Current state driver’s license.
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. 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
