Description
Position Purpose: Role will lead strategy development and execution for the growing ICHRA product, including building provider networks with dedicated rates across current and future markets for both Centene employees and external members. Expand the provider network development and value based contracting activities. Assist with value based contracting provider network strategy, including provider contract negotiation, development of new value-based models, drive provider performance related to quality and reduction of avoidable healthcare costs, assist with preparation for provider performance meetings, and support decision makers with analysis related to historical and projected provider performance.
- Develop relationships in multiple markets and implement strategies with key providers, provider associations and provider stakeholders.
- Lead key provider negotiations with Hospitals, Physicians, Ancillaries, and Community Health Centers.
- Develop and implement network development strategy plans with key providers in multiple markets.
- Oversee the development of provider networks across expansion markets.
- Manage budgeting and forecasting initiatives for stakeholder/network strategies, product lines, networks costs, and/or provider contracts.
- Develop, coordinate and managed provider advisory boards, committee’s and governance and maintain relationships with key provider leadership.
- Assist and advise on key provider relations and strategies.
- Evaluating opportunities to expand or change the network to meet company goals.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience: Bachelor's Degree in Business, Management, Healthcare Administration, or related field required.
MBA preferred.
10+ years of healthcare administration, network development, or provider/payor contracting experience in a healthcare or managed care environment required.
Provider network development and strategy, provider contract negotiations, leading network development staff, unit cost and network strategy budgeting.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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
