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Senior Director, Provider Network Performance

Role overview

Qualifications

  • Bachelor's degree in business administration, healthcare administration, or related field required
  • Master’s degree preferred
  • 8+ years of provider relations or contracting experience, preferably in a managed care or Medicaid environment
  • Previous management experience including responsibility for hiring, training and managing performance of staff

Responsibilities

  • Oversee provider network performance and communications to improve quality and access at lower costs
  • Oversee provider satisfaction programs and initiatives, best practices, and reporting tools in partnership with leaders across the enterprise
  • Develop and implement plans and tactics to deploy and expand provider engagement model across corporate functional areas and the health plans
  • Oversee and direct the resolution of complex provider projects including direct communication with providers

Key facts

Hard skills

Other skills

  • Communication
  • Training And Development
  • Team Leadership

About the company

Centene Corporation logo

Centene Corporation

  • Health Insurance & Payers
  • XLarge
  • 10,001+
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/

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Job description

This is a remote position but does require travel into the NY offices, so would prefer a candidate in NY or bordering states.


Position Purpose: Oversee provider network performance and communications across the company to inform and educate providers and improve quality of care.


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


  • Oversee provider network performance and communications to improve quality and access at lower costs and to maintain compliance with policies and standards, government laws and regulations
  • Oversee provider satisfaction programs and initiatives, best practices, and reporting tools in partnership with leaders across the enterprise
  • Oversee the communication and training to providers on products, services, and various tools
  • Develop enterprise metrics and reporting tools
  • to support quality and cost improvement activities
  • Develop and implement plans and tactics to deploy and expand provider engagement model across corporate functional areas and the health plans
  • Oversee implementation of all provider education materials and monitor policies and procedures
  • Develop tactical plans to align strategies and technologies with future needs
  • Partner with other leaders (Credentialing, PDM, Contracting, Shared Services) to ensure accuracy of provider related data
  • Oversee and direct the resolution of complex provider projects including direct communication with providers
Education/Experience: Bachelor's degree in business administration, healthcare administration, related field required. Master’s degree preferred. 8+ years of provider relations or contracting experience, preferably in a managed care or Medicaid environment. Previous experience leading major projects and change initiatives preferred. Previous management experience including responsibility for hiring, training and managing performance of staff.

License:Pay Range: $134,600.00 - $249,000.00 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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