Staff Vice President, Medicare Quality & Affordability Strategy

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.
 

Accountable for developing and implementing strategic programs to manage healthcare trends and drive population health solutions in collaboration with internal and external stakeholders. Individual will identify patient cohorts and develop a cohesive coordinated strategy for Medicare LOB and individual markets to manage trend for high cost (and at risk of high cost) members. Must work across the enterprise to communicate strategy and implement various pop health solutions to mitigate trend.

• Lead a coordinated approach for the strategic analysis of utilization patterns, cost drivers, and emerging healthcare trends to develop targeted interventions that improve health outcomes and reduce costs.
• Provides deep industry expertise, thought leadership and consultative insights around best in class practices.
• Partner with providers, specialists, utilization management, care management, and select vendors to design and implement innovative solutions that optimize care delivery.
• Collaborate with key cross functional partners and Health Plans to assess trends and develop forecasts, ensuring sustainable strategies. Must be able to work across multiple departments to implement internal and external initiatives to mitigate trend
• Drive adoption of data-driven, risk adjusted care models to enhance disease management and preventive care strategies
• Translate strategic objectives from business transformation initiatives into actionable plans and ensure flawless execution of those plans.
• Develop, prioritize, and execute business process excellence initiatives to identify opportunities for operational efficiencies across the segment.
• Support successful contract implementation and development of new programs by developing and administering individual project plans, ensuring alignment with organizational goals.
• Conduct oversight meetings which include vendors, internal partners, and other stakeholders as appropriate.
• Establish, monitor, and report on vendor performance metrics.

Education and Experience Requirements:

• Bachelor’s degree in business administration, Healthcare Administration or related field.  Master’s degree in business, Finance or related field preferred.
• 10+ years of experience in healthcare operations, finance, or clinical vendor management required. 
• Strong expertise in Medicare cost trend analysis, population health management and value-based care models preferred.
• Proven track record of effectively engaging with members of Senior Leadership.

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