Director, Contracting & Network Development

PA Health & Wellness; Bent Creek (NC); Remote; USD 135.000 - 249.000; Vollzeit

Zusammenfassung

Centene is seeking a Senior Director to oversee provider contracting, network development and provider relations across markets. This remote role requires occasional travel within Pennsylvania and involves aligning contracting strategies with organizational policies and regulatory requirements.

You will lead teams, manage external consultants, perform financial analyses to drive cost improvements, and help launch new networks in diverse markets.

Qualifikationen

• Bachelor's degree in Business Administration, Health Care Administration, or related field, or equivalent experience.
• 7+ years of combined contracting, network development or provider relations experience.
• Experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements.
• Management experience including responsibilities for hiring, training, and supervising staff.
• Valid driver's license.

Aufgaben

• Oversee provider contracting activities to ensure efficiency and compliance with policies and laws.
• Implement development activities for recruitment and contracting of provider networks in new and existing markets.
• Support new business launches in diverse markets considering market circumstances and resources.
• Perform complex financial analyses to identify medical cost improvement opportunities and contracting strategies.
• Oversee contracting and network development staff and external consultants.
• Monitor performance and communicate network strategy and planning.
• Ability to travel.

Kenntnisse

Provider contracting

Network development

Provider relations

Staff management

Negotiation

Ausbildung

Bachelor's degree or equivalent

Jobbeschreibung

Position Purpose:

Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.

• Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations
• Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
• Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
• Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
• Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ability to travel

Education/Experience:

Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience. 7+ years of combined contracting, network development or provider relations experience. Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements. Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff. License/Certification: Valid driver's license.

Applicants must be in the state of Pennsylvania to be considered for this role. This is a remote position that requires occasional travel across the state of Pennsylvania for internal and provider-facing meetings.

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