Remote Value-Based Care Performance Manager

Centene Corp.; Clayton, Northern (MO, KY); Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work schedules

Job summary

Centene Corp. is seeking a Provider Relations professional to develop strategic partnerships between the health plan and contracted provider networks. You will engage with providers to align on network performance opportunities and implement performance improvement initiatives.

Role requires managing provider performance in HEDIS/quality, cost and utilization with a consultative approach, educating on policies, referrals, and claims. Travel up to 4 days per week is expected.

Qualifications

• Bachelor’s degree in related field or equivalent experience.
• Three or more years of managed care or medical group experience.
• Strong communication and presentation skills.
• Proficient in HEDIS/Quality measures and cost/utilization awareness.
• Experience with Value Based Care highly preferred.

Responsibilities

• Develop strategic partnerships between the health plan and the contracted provider networks serving our communities.
• Engage with providers to align on network performance opportunities and solutions.
• Drive provider performance improvement in HEDIS/quality, cost and utilization.
• Provide consultative account management and issue resolution with providers.
• Travel locally up to 4 days a week as needed.

Skills

Communication

Presentation skills

Value Based Care understanding

Education

Bachelor’s degree or equivalent experience

Tools

HEDIS/Quality measures

Job description

Centene Corp. is seeking a Provider Relations professional to develop strategic partnerships between the health plan and contracted provider networks. You will engage with providers to align on network performance opportunities and implement performance improvement initiatives.

Role requires managing provider performance in HEDIS/quality, cost and utilization with a consultative approach, educating on policies, referrals, and claims. Travel up to 4 days per week is expected.