Provider Performance Manager

Centene Corporation; United States; Remote; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401(k) and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible remote/hybrid/work schedules

Job summary

Centene Corporation is seeking a remote-based Provider Contract Performance Specialist to collaborate with healthcare providers on value-based contracts across the United States.

Responsibilities include developing KPIs, negotiating contracts, guiding process improvements, and training provider staff to improve clinical and operational outcomes. Travel occasional; remote work option nationwide; salary range $56,200–$101,000 with comprehensive benefits.

Qualifications

• 3+ years of value-based contracting, managed care, or process and performance improvement experience.
• Project and/or program management experience highly preferred.

Responsibilities

• Collaborates with provider staff to develop and implement operational and clinical process improvements.
• Identify, develop, and establish key performance metrics to measure performance of providers related to value-based contracts.
• Negotiate contracts and monitor providers’ performance standards and financial performance.
• Provide training and support to provider staff to understand performance metrics.
• Promote collaboration across provider groups to share best practices and improvement opportunities.
• Lead and participate in internal/external meetings with VBC team and PHCO clinical teams.

Skills

Value-based contracting

Contract negotiation

Process improvement

Performance metrics

Training & enablement

Education

Bachelor's degree in Business Administration/Finance/Public Health

Master's degree in Business Administration/Finance/Public Health

Job description

Position Purpose: Collaborate with healthcare providers to help them achieve high performance with their value based contracts.

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.

• Collaborates with provider staff to develop and implement operational and clinical process improvements to help providers achieve higher performance
• Identify, develop, and establish key performance metrics to measure performance of providers related to their value based contracts.
• Identify improvement opportunities based on key performance indicators and develop action plans
• Develop and provide training and support to provider staffs to assist them in understanding performance metrics and implement operational and clinical improvements
• Promote collaboration across provider groups to enable sharing of best practices and performance improvement opportunities
• Resolve various system, process or resource issues to address provider feedback and concerns
• Negotiate contracts
• Evaluate and monitor providers’ performance standards and financial performance of contracts.
• For Population Health :
• Build collaborative relationships with internal and external customers to facilitate process improvement and improved clinical outcomes
• Participate in internal and externa customer meetings with providers, VBC team and internal PHCO clinical team
• Participate in Joint Operating Committees (JOC’s) with VBC providers, VBC team and internal PHCO clinical team
• Lead and support clinical/quality discussion on behalf of the internal Care Management team
• Work in accordance with corporate team to develop and improve departmental processes and procedures
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience:
Bachelor’s Degree in Business Administration, Finance, Public Health, or a related field required. Master’s Degree in Business Administration, Finance, Public Health, or a related field preferred. 3+ years of value-based contracting, managed care, or process and performance improvement experience required. Project and/or program management experience is highly preferred.

This is a remote position open to someone working anywhere in the United States, but Central and Eastern time zones are the preferred locations. It may require occasional travel a few times/year.

Pay Range: $56,200.00 - $101,000.00 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