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Position Purpose: Oversee provider network and contracting related activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management.
Oversee the coordination and negotiation for the contracting department, including analysis of various information to support contract negotiations.
Ensure development of provider networks across expansion markets.
Evaluate provider network cost, coverage, and growth and recommend expansion opportunities.
Oversee budgeting and forecasting initiatives for various product lines to networks costs and provider contracts.
Review provider contracting rates to ensure strategic focus is on target with overall company strategy.
Participate in unit cost and selective contracting initiatives.
Establish the department’s strategic vision, objectives, and policies and procedures, including developing, implementing, and maintaining production and quality standards.
Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
Assist health plan CEO and/or COO vendors in key provider relations and strategy.
Performs other duties as assigned.
Complies with all policies and standards.
Education/Experience: Bachelor's Degree or equivalent, in Business Administration, Healthcare Administration or related field required.
MBA or MHA degree preferred.
10+ years of network development and provider relations or contracting management in a health care or managed care environment required.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Valid driver’s license.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.Pay Range: $207,000.00 - $392,100.00 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
