Description
Position Purpose: With the Corporate Operations team, you will manage third party program relationships with Delegation partners for performance management standards, financial responsibility, and proactively implements appropriate business solutions as required. Duties will include: Vendor Relationship Management, Contract Oversight, Performance Management, Risk and Compliance reviews, Strategic Vendor Management and Governance and Process.
Key Details: This is a fully remote role. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
- Serve as a key account manager for assigned vendors, ensuring effective communication, compliance with contracts, and optimal performance.
- Manage vendor utilization including workflows for coordinating services with the Health Plan, and/or Operations Departments/ Enterprise.
- Provide and share monthly SLA performance dashboards and/or reporting with Delegated entity and address issues in performance of assigned SLAs.
- Develop correction action plans for standards that are not met by the vendor and implement correction action plans when necessary.
- Track, analyze, and report on vendor performance and opportunities for improvement.
- Create and manage vendor scorecard and associated ratings/correction plans.
- Coordinate with Medical Management, Member Services, and Provider Services to educate and communicate expectations, performance and procedures to vendors.
- Schedule and conduct monthly meetings with Delegated entities and document discussions, issues, attendees, and action items.
- Research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution.
- Work closely with internal stakeholders to ensure vendors meet business needs and objectives.
- Receive and respond to provider related database information requests and concerns.
- Ensure operation integrity, including compliance with all policies and procedures for including adherence to state contract and guidelines.
Education/Experience: Bachelor's Degree Business Administration, Public Administration or related field or equivalent experience required.
7+ years' experience supporting working with Primary Care Providers, Account Management experience working in healthcare or related field required.
3+ years' experience in vendor management or procurement required.
Demonstrated ability to cultivate strong relationships with internal stakeholders
and external vendors to enhance business outcomes and drive engagement.
Able to present to executive-level teams at the delegated entities.
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
