Centene Corp

Vice President, Prospective Programs (Remote)

Centene Corp • $188K — $359K *
US-AnywhereRemote in Missouri, US
Healthcare
8 - 10 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's Degree in healthcare administration, business, clinical discipline, health information management, finance, analytics, or related field required.
  • Master's degree in a related field preferred.
  • 10+ years of progressive healthcare leadership experience, particularly in risk adjustment and provider engagement.
  • Experience leading enterprise programs across multiple markets (Medicare, Marketplace, Medicaid) required.
  • Strong knowledge of risk adjustment methodologies and healthcare operations.

Responsibilities

  • Lead enterprise prospective risk adjustment strategy and governance across all lines of business.
  • Oversee vendor strategy performance for In-Home Assessments and In-Office Assessments, ensuring alignment with business priorities.
  • Own and execute CoC+ program strategy, coordinating with various stakeholders for optimal performance.
  • Develop strategies for provider education and clinical documentation improvement to enhance documentation quality.
  • Establish governance processes and accountability frameworks for operational excellence across programs.

Benefits

  • Comprehensive health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible work options including remote, hybrid, or office schedules.
Full Job Description

Position Purpose:

Strategic lead for Centene’s enterprise prospective risk adjustment programs across Medicare, Marketplace, and Medicaid lines of business. Responsible for the strategic direction, operational performance, and governance of prospective risk adjustment initiatives, including provider engagement, clinical documentation improvement, member assessment programs, in office assessment programs, and prospective program vendor management. Drives program effectiveness, compliance, and cross-functional collaboration to improve documentation accuracy, risk adjustment outcomes, and business performance.

Responsibilities:

  • Lead enterprise prospective risk adjustment strategy, operations, and governance across all lines of business.
  • Oversee IHA (In-Home Assessments) vendor strategy and performance, including vendor selection, contract negotiation, capacity planning, outreach effectiveness, visit completion, claims submission, invoice accuracy, service-level performance, and issue resolution.
  • Lead IOA (In-Office Assessments) vendor oversight and program strategy, ensuring vendor programs are aligned to business priorities, provider workflows, risk adjustment goals, compliance expectations, and market needs.
  • Own CoC+ (Continuity of Care Plus) program strategy and execution, including program design, provider enablement, appointment agenda adoption, performance monitoring, and cross-functional coordination with Quality, Network, and local market partners.
  • Develop and execute provider education and CDI (Clinical Documentation Improvement) strategies that strengthen documentation quality, improve provider understanding of risk adjustment requirements, and support accurate and complete documentation of acuity.
  • Oversee prospective program performance, including provider-facing initiatives, assessment programs, documentation improvement efforts, and vendor partnerships.
  • Establish performance measures, governance processes, and accountability frameworks to support operational excellence and risk mitigation.
  • Partner with market, clinical, quality, provider engagement, finance, compliance, network, claims, and technology leaders to improve program outcomes and organizational performance.
  • Provide enterprise leadership and accountability for prospective program operations across lines of business, markets, vendors, provider groups, and functional partners.
  • Serve as a strategic advisor to executive leadership regarding prospective risk adjustment performance, opportunities, and enterprise priorities.
  • Partner closely with Procurement, Vendor Management, Finance, Claims, Compliance, Quality, local market teams, Provider Engagement, and Technology to align contracts, resources, reporting, and program priorities.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience:

  • Bachelor's Degree in healthcare administration, business, clinical discipline, health information management, finance, analytics or related field required.
  • Master's degree in a related field preferred.
  • 10+ years of progressive healthcare leadership experience, including risk adjustment, provider engagement, clinical documentation improvement, quality or related healthcare operations required.
  • Experience leading enterprise programs across multiple markets and lines of business (Medicare, Marketplace, Medicaid) required.
  • Demonstrated success leading strategic initiatives, provider-facing programs, vendor partnerships, and cross-functional teams required.
  • Experience managing vendor strategy and performance, including contract compliance, service delivery, financial reconciliation, and corrective action initiatives required.
  • Strong knowledge of risk adjustment methodologies, healthcare operations, provider documentation, and regulatory requirements required.
  • Proven executive leadership, communication, and stakeholder management skills required.
  • Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range: $188,900.00 - $359,800.00 per year

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.

About Centene Corp

Centene Corporation is a managed healthcare enterprise at the forefront of innovation and growth for government-sponsored and commercial healthcare, providing access to fully integrated, high-quality, and cost-effective services that help people lead healthier lives. The company’s local approach addresses the needs of under-insured and uninsured individuals who often lack the resources required to sustain optimal health and wellness. Centene began as a single health plan in Milwaukee, Wisconsin in 1984. After an initial period of growth, Michael Neidorff joined as President and Chief Executive Officer (CEO) in 1996, moving Centene’s headquarters to St. Louis, Missouri, where it still resides today. In the decades since its humble beginnings, Centene has transformed into a publicly-traded Fortune 500 company serving communities across the United States. In fact, Centene provides coverage in all 50 U.S. states. More than 26 million Americans rely on Centene to access a wide range of insurance solutions, including Medicaid, Medicare, TRICARE, correctional, and behavioral health services. Centene prioritizes the development of technology that addresses systemic conditions impacting the whole health needs of underserved populations. As technology plays an increasingly critical role in diagnosing, managing, and treating disease, Centene understands that it enables better health outcomes for members, lessening the burden for providers, and allowing more automation and efficiency for business operations. As a steward of a significant set of data and insights, Centene leverages this data to not only shape but lead the digital transformation of healthcare and improve the patient-provider experience. Centene’s current CEO, Sarah London, and her team are leading the charge in this new age. Sarah London worked within Centene’s Technology Innovation and Modernization division, spearheading the company’s enterprise-wide technology strategy. Now leading Centene, her focus is on building the next generation of products and services and establishing Centene’s long-term growth and value creation. Although Centene has grown into the No. 1 insurer in the U.S. Health Insurance Marketplace, it has never lost its focus on the individual or its passion for community health. Remaining connected to the individuals and families that need care most is central to Centene’s commitment to shaping a better world of healthcare for the communities it serves. Centene also remains connected to the needs of its employees, who make Centene what it is. Through its commitment to diversity, equity, and inclusion practices, Centene promotes a safe and inviting environment above all. Because of Centene’s commitment to excellence and progression in the healthcare industry, it has been recognized as a Top Organization for Diversity by Modern Healthcare magazine, a Leading Disability Employer by the National Organization on Disability, a Best Place to Work for LGBTQ Equality by The Human Rights Campaign Foundation, and a global leader by Bloomberg’s Gender-Equality Index, among many other recognitions. Centene was also named a Top 50 Company for Diversity by DiversityInc and a Top Veteran-Friendly Company by U.S. Veterans Magazine. It has also been listed on FORTUNE® magazine's list of the World's Most Admired Companies for several consecutive years.

Centene Corp Careers

Join the dynamic team at Centene Corp, a leader in the healthcare industry, where your career growth and development are prioritized. At Centene Corp, we offer a range of job opportunities that allow you to make a significant impact on our community and beyond.

Explore a World of Opportunities

Discover the diverse career paths available at Centene Corp, from healthcare services to innovative program development. Our job opportunities span various professional fields, offering positions that cater to your unique skills and ambitions. Whether you're looking for an entry-level role or a senior leadership position, Centene Corp is committed to hiring top talent and fostering a culture of excellence.

Innovation and Leadership at Centene Corp

At Centene Corp, innovation and leadership go hand in hand. We empower our team members to lead with confidence and creativity, driving the company forward through strategic innovation and robust leadership. Our leadership programs are designed to cultivate your skills, helping you to thrive as a professional and make meaningful contributions to our company and the communities we serve.

Internships and Early Career Programs

Kickstart your career with Centene Corp through our internship and early career programs. These opportunities provide hands-on experience and a glimpse into the dynamic world of healthcare management. Internships at Centene Corp are a stepping stone to full-time employment, offering invaluable networking opportunities, mentorship, and the chance to develop your resume and interview skills in a real-world setting.

Commitment to Diversity and Inclusive Culture

Centene Corp is dedicated to maintaining a diverse and inclusive work environment. We believe that diversity fuels innovation and enhances our team's performance. Our diversity training ensures that all team members appreciate and leverage the broad range of experiences and perspectives that each individual brings to the company.

Benefits and Employee Growth

We value our employees' well-being and career aspirations. Centene Corp offers competitive benefits, including health insurance, retirement plans, and professional development programs. Our commitment to your growth is reflected in our continuous learning initiatives and performance management processes that help you achieve your career goals.

Join Our Team

Are you ready to advance your career at Centene Corp? Explore our current job openings and find the position that best matches your skills and interests. We are looking for passionate, curious, and solution-driven team players who are ready to make a difference.

Stay Connected with Centene Careers

Keep up to date with the latest career tips, insider perspectives, and industry-leading insights—all from the people who work at Centene Corp. Personalize your subscription to receive job alerts, latest news, and insider tips tailored to your preferences. Discover the exciting and rewarding opportunities that await you at Centene Corp.

SEARCH CENTENE JOBS

Centene Corp is not just a company—it's a place where you can shape your future and impact the lives of millions. Join us in our mission to transform the health of the community, one person at a time.
Learn more about Centene Corp
Size
72,500 employees
Market Cap
$46.5 billion
Industry
Healthcare
Net Income
$1.8 billion
Founded
1984
5 Year Trend
+25.4%
Revenue
$111.1 billion
NASDAQ
CNC
* Ladders Estimates

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