Senior Director, Provider Network Performance

Centene Corporation; Connecticut; Remote; USD 135,000 - 249,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible remote/hybrid/office schedule

Job summary

Centene is seeking a provider relations leader to oversee provider networks, performance, and communications across the company, aimed at improving quality of care and cost efficiency while maintaining compliance.

The role requires a Bachelor's degree (Master’s preferred) and 8+ years in provider relations or contracting, with proven experience in managing major projects and teams; the position is remote with travel to NY offices as needed.

Qualifications

• Bachelor's degree in business administration, healthcare administration, related field required.
• Master’s degree preferred.
• 8+ years of provider relations or contracting experience, preferably in a managed care or Medicaid environment.
• Previous management experience including responsibility for hiring, training and managing performance of staff.

Responsibilities

• Oversee provider network performance and communications to improve quality and access at lower costs and to maintain compliance with policies and standards, government laws and regulations
• Oversee provider satisfaction programs and initiatives, best practices, and reporting tools in partnership with leaders across the enterprise
• Oversee the communication and training to providers on products, services, and various tools
• Develop enterprise metrics and reporting tools
• to support quality and cost improvement activities
• Develop and implement plans and tactics to deploy and expand provider engagement model across corporate functional areas and the health plans
• Oversee implementation of all provider education materials and monitor policies and procedures
• Develop tactical plans to align strategies and technologies with future needs
• Partner with other leaders (Credentialing, PDM, Contracting, Shared Services) to ensure accuracy of provider related data
• Oversee and direct the resolution of complex provider projects including direct communication with providers

Skills

Provider relations

Contracting experience

Project leadership

Regulatory compliance

Education

Bachelor's degree in business administration or healthcare administration

Master’s degree preferred

Job description

This is a remote position but does require travel into the NY offices, so would prefer a candidate in NY or bordering states.

Position Purpose

Oversee provider network performance and communications across the company to inform and educate providers and improve quality of care.

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

• Oversee provider network performance and communications to improve quality and access at lower costs and to maintain compliance with policies and standards, government laws and regulations
• Oversee provider satisfaction programs and initiatives, best practices, and reporting tools in partnership with leaders across the enterprise
• Oversee the communication and training to providers on products, services, and various tools
• Develop enterprise metrics and reporting tools
• to support quality and cost improvement activities
• Develop and implement plans and tactics to deploy and expand provider engagement model across corporate functional areas and the health plans
• Oversee implementation of all provider education materials and monitor policies and procedures
• Develop tactical plans to align strategies and technologies with future needs
• Partner with other leaders (Credentialing, PDM, Contracting, Shared Services) to ensure accuracy of provider related data
• Oversee and direct the resolution of complex provider projects including direct communication with providers

Education/Experience

Bachelor's degree in business administration, healthcare administration, related field required. Master’s degree preferred. 8+ years of provider relations or contracting experience, preferably in a managed care or Medicaid environment. Previous experience leading major projects and change initiatives preferred. Previous management experience including responsibility for hiring, training and managing performance of staff.

License

Pay Range: $134,600.00 - $249,000.00 per year

About Centene

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.

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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