Remote Provider Performance & Process Improvement Lead

Centene Corp.; Clayton, Northern (MO, KY); Hybrid; USD 56,000 - 101,000; Full time

Job summary

Centene Corp. in Clayton, MO, seeks a Provider Performance Manager to collaborate with healthcare providers to improve performance under value-based contracts. This remote role supports providers nationwide and may require occasional travel.

You will develop operational and clinical process improvements, establish KPIs, train provider staff, and lead cross-functional discussions with the VBC team and PHCO clinical group to enhance outcomes.

Qualifications

• Bachelor's degree in Business Administration, Finance, Public Health, or related field required.
• Master's degree preferred.
• 3+ years of value-based contracting, managed care, or process and performance improvement experience.
• Authorized to work in the U.S. without visa sponsorship.

Responsibilities

• 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.
• For Population Health: Build collaborative relationships with internal and external customers to facilitate process improvement and improved clinical outcomes.
• Participate in internal and external 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.

Skills

Value-based contracting

Managed care

Performance improvement

Stakeholder collaboration

Training & coaching

Education

Bachelor's Degree

Master's Degree

Job description

Centene Corp. in Clayton, MO, seeks a Provider Performance Manager to collaborate with healthcare providers to improve performance under value-based contracts. This remote role supports providers nationwide and may require occasional travel.

You will develop operational and clinical process improvements, establish KPIs, train provider staff, and lead cross-functional discussions with the VBC team and PHCO clinical group to enhance outcomes.