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Provider Performance Manager

Role overview

Qualifications

  • Bachelor's Degree in Business Administration, Finance, Public Health, or a related field
  • Master's Degree preferred
  • 3+ years of value-based contracting experience
  • Experience in managed care or process and performance improvement

Responsibilities

  • Collaborate with provider staff to develop and implement operational and clinical process improvements
  • Identify and establish key performance metrics
  • Develop action plans based on key performance indicators
  • Provide training and support to provider staff regarding performance metrics

Key facts

Hard skills

Other skills

  • Collaboration
  • Training And Development
  • Problem Solving
  • Communication

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Position Purpose: Collaborate with healthcare providers to help them achieve high performance with their value based contracts.

Key Details: 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.

  • Collaborates with provider staff to develop and implement operational and clinical process improvements to help providers achieve higher performance
  • Identify, develop, and establish key performance metrics to measure performance of providers related to their value based contracts.
  • Identify improvement opportunities based on key performance indicators and develop action plans
  • Develop and provide training and support to provider staffs to assist them in understanding performance metrics and implement operational and clinical improvements
  • Promote collaboration across provider groups to enable sharing of best practices and performance improvement opportunities
  • Resolve various system, process or resource issues to address provider feedback and concerns
  • For Population Health :
  • Build collaborative relationships with internal and external customers to facilitate process improvement and improved clinical outcomes
  • Participate in internal and externa customer meetings with providers, VBC team and internal PHCO clinical team
  • Participate in Joint Operating Committees (JOC's) with VBC providers, VBC team and internal PHCO clinical team
  • Lead and support clinical/quality discussion on behalf of the internal Care Management team
  • Work in accordance with corporate team to develop and improve departmental processes and procedures
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience:
Bachelor's Degree in Business Administration, Finance, Public Health, or a related field required. Master's Degree preferred. 3+ years of value-based contracting, managed care, or process and performance improvement experience required.

This is a remote position open to someone working anywhere in the United States, but Central and Eastern time zones are the preferred locations. It may require occasional travel a few times/year.

Pay Range: $56,200.00 - $101,000.00 per year

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

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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