Senior Manager, Provider Relations

Centene Management Company LLC

Deutschland

Vor Ort

EUR 76.000 - 137.000

Vollzeit

14 Tage+

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Benefits dieser Stelle

Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible work arrangements (remote,hyb
Hybrid/Remote work options

Zusammenfassung

Centene Management Company LLC is seeking a senior leader to oversee Provider Relations across our markets. You will lead a team of Provider Relations Representatives, Supervisors, and Network Performance Advisors to meet performance targets and drive network transformation strategies.

You will coach, monitor, and develop team skills, ensure regulatory compliance, and collaborate with Quality teams to improve provider performance and member outcomes.

Qualifikationen

  • Bachelor's degree required in a related field.
  • Minimum 6+ years of experience in provider relations or similar background.
  • Minimum 3+ years of management experience.

Aufgaben

  • Leads and develops Provider Relations team to manage the assigned region/market.
  • Develops and executes network transformation strategies to improve market performance.
  • Mentors and conducts field coaching with representatives and supervisors; documents progress.
  • Ensures regulatory and contractual compliance and drives provider performance improvement.

Ausbildung

Bachelor's Degree in a related field

Jobbeschreibung

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. Please note: candidates must reside in DE, MD, NJ or PA.

Position Purpose
  • Leads team of Provider Relations Representatives, Network Performance Advisors and/or Provider Relations Supervisors to effectively manage assigned region and/or market territory.
  • Develops Provider Relations Team to achieve market performance targets through the implementation and execution of network transformation strategies in order to improve overall Network Performance.
  • Works with a team—Leads and develops a team of Provider Relations Representatives, Provider Relations Supervisors and/or Network Performance Advisors. Conducts ride-alongs with Reps in the field to develop skills and behaviors and document progress/provide formative feedback through timely and consistent Field Trip Reports.
  • Identifies team skill set deficiencies and implements proper professional development plans.
  • Monitors Provider Performance action plans and tracks provider performance improvement.
  • Ensures compliance with enterprise provider performance and relationship model and team engagement of provider performance reporting.
  • Responsible for understanding the differences between Risk and Value-Based contractual arrangements.
  • Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive improvement of quality provider performance.
  • Plans, prepares and executes effective group meetings/discussions with proper objectives and outcomes.
  • Ensures adherence to contractual obligations and to regulatory requirements.
  • Identifies areas of opportunity to improve Provider Satisfaction and Provider Experience.
  • Assists in monitoring and developing High Performing Practices and driving Network Transformation Strategies to optimize member outcomes.
  • Educates and enhances provider partnerships and implements market and enterprise initiatives.
  • Strategizes membership growth for High Performing Practices and/or sophisticated complex provider relationships.
  • Provides training, mentoring and guidance to new managers.
  • Special projects as assigned or directed.
Additional Responsibilities
  • Leads and develops Provider Operations staff.
Candidate Education
  • Required A Bachelor's Degree in a related field.
Experience
  • Required or equivalent work experience.
  • Required 6+ years of experience in provider relations or similar background.
  • Required 3+ years of management experience.
Pay Range
  • Pay Range: $87,700.00 - $157,800.00 per year
Benefits
  • 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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