Senior Director, Contracting & Network Development

centene; Town of Florida (NY); Teletrabalho; USD 135 000 - 249 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health insurance

401K and stock options

Tuition reimbursement

Paid time off and holidays

Remote/hybrid/work flexibility

Resumo da oferta

Centene is seeking a Senior Hospital Contracting Leader to oversee evaluation, negotiation and management of hospital contracts across Medicare, Medicaid, Marketplace and related programs. The role focuses on network strategy, market expansion, and cost objectives in a remote setting with travel in Florida.

Ideal candidates have a Bachelor's in Healthcare Administration or related field, 7+ years of hospital contracting experience; a Master's degree is preferred.

Qualificações

• Bachelor’s degree in Healthcare Administration, Business Administration, related field or equivalent experience.
• 7+ years of related hospital contracting experience.
• Experience establishing new markets including the development of the hospital network strategy and oversight of the implementation.
• Master's degree is preferred.

Responsabilidades

• Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between health plan and hospitals to include Medicare, Medicaid, Marketplace, and ICHRA.
• Work with business development and providers to develop a strategy for developing new networks/partnership strategies including plans to meet network access and unit cost objectives.
• Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources.
• Monitor performance, develop, and implement business solutions to address process and quality gaps.
• Communicate with senior management and other Centene leaders regarding network strategy and planning.
• Complete negotiations and re-negotiations with complex and major hospital systems as needed to support network objectives.
• Maintain hospital network and contract reporting to include contract language assessments by product and claims volume
• Performs other duties as assigned
• Complies with all policies and standards

Formação académica

Bachelor's degree in Healthcare Administration or related field

Master's degree preferred

Descrição da oferta de emprego

Position Purpose: Oversee the development and implementation of hospital provider contracting activities in network development and enhancement.

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.

• Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between health plan and hospitals to include Medicare, Medicaid, Marketplace, and ICHRA.
• Work with business development and providers to develop a strategy for developing new networks/partnership strategies including plans to meet network access and unit cost objectives.
• Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources.
• Monitor performance, develop, and implement business solutions to address process and quality gaps.
• Communicate with senior management and other Centene leaders regarding network strategy and planning.
• Complete negotiations and re-negotiations with complex and major hospital systems as needed to support network objectives.
• Maintain hospital network and contract reporting to include contract language assessments by product and claims volume
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience:

Bachelor’s degree in Healthcare Administration, Business Administration, related field or equivalent experience. 7+ years of related hospital contracting experience. Experience establishing new markets including the development of the hospital network strategy and oversight of the implementation.

Master's degree is preferred.

Candidates must be in Florida to be considered for this role.

This is a remote position, but it will require occasional travel throughout Florida 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.