You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: This role will be responsible for leading a new function for out of network management, and related functions, for Centene’s Marketplace products. The scope will evolve as the team takes form, inclusive of network development, contracting, reimbursement, analysis, policy development, and advocacy.
Key Responsibilities:
- Oversee network development staff and external consultants in the development of provider networks across markets.
- Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
- Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
- Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
- Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
- Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
- Assist health plan CEO and vendors in key provider relations and strategy.
- Work collaboratively with Business Development on new market and new product development initiatives.
- Ability to travel.
Education/Experience: Bachelor's degree in Business Administration, Healthcare Administration, related field or equivalent experience. 7+ years of experience in managed care network development. 3+ years of experience in government programs. MBA or MHA degree preferred. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
License/Certification: Valid driver's license.
Pay Range: $142,300.00 - $263,500.00 per year.
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.
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