Senior Director, Provider Network Performance

Centene Corp.; Trenton (NJ); Remote; USD 135,000 - 249,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements (remote/hyr

Job summary

Centene Corp. is seeking a senior leader to oversee provider network performance and communications, driving quality, access, and cost efficiency across the enterprise.

The role requires a Bachelor's degree and 8+ years in provider relations or contracting, with preferred Master’s degree and prior management experience in managed care or Medicaid environments.

Qualifications

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

Responsibilities

• Oversee provider network performance and communications to improve quality and access while maintaining compliance.
• Oversee provider satisfaction programs and reporting tools in partnership with enterprise leaders.
• Oversee communications and training to providers on products, services, and tools.
• Develop enterprise metrics and reporting tools.
• Support quality and cost improvement activities.
• Develop and implement plans to deploy and expand the provider engagement model.
• Oversee implementation of provider education materials and monitor policies and procedures.
• Develop tactical plans to align strategies and technologies with future needs.
• Partner with Credentialing, PDM, Contracting, Shared Services to ensure data accuracy.
• Direct resolution of complex provider projects including direct communication with providers.

Skills

Provider relations

Contracting

Leadership

Project management

Education

Bachelor's degree

Master's degree

Job description

Business Area: Provider Networking & Contracting

Job Type: Full time

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

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
• 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