Centene Corp

Vice President, Provider Engagement

Centene Corp • $188K — $359K *
New City, NY 10956In-Person
Healthcare
8 - 10 years of experience
2 months ago
Job Overview by Ladders

Qualifications

  • Bachelor's Degree required; Master's Degree preferred
  • 9+ years of experience in senior leadership roles within a managed care environment
  • Experience in developing provider networks and building partnerships preferred
  • In-depth understanding of healthcare industry practices
  • Strong knowledge of claim processing and health plan operations

Responsibilities

  • Develop and execute strategies for transforming market-level provider payment programs
  • Analyze metrics to enhance provider performance and focus on quality measures like HEDIS and STARS
  • Manage complex relationships with providers to boost satisfaction and value-based performance
  • Facilitate collaboration between providers and healthcare plans to optimize operational efficiency
  • Lead corporate initiatives related to provider engagement and performance
  • Oversee provider credentialing processes compliant with industry standards
  • Monitor trends in provider networks and develop strategies to leverage them

Benefits

  • Comprehensive benefits package including health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Generous paid time off and holidays
  • Flexible work arrangements (remote, hybrid, or office work)
Full Job Description

Position Purpose: This leader advances payment models/programs that improve quality, affordability, provider performance, and member outcomes while ensuring alignment with Fidelis Care’s network strategy, line of business priorities, state specific needs, and regulatory requirements. This role is responsible for leading all aspects of provider services, including building and maintaining strong provider relations with key providers and working closely with various operational areas to support provider services, quality initiatives, network development, data quality initiatives, claim processing and expansion of the markets served by the company. The VP of Provider Engagement works closely with others to ensure that members have access to best-in-class service providers and that members receive quality care at reasonable costs.

  • Strategic Leadership: Develops and implements market-level network value based program transformation initiatives. Develop and execute overarching strategies to optimize provider performance, operations and satisfaction across the market.
  • Provider Performance & Quality: Analyzes and communicates financial, utilization, and quality metrics to improve performance, specifically focusing on HEDIS and STARS measures.
  • Relationship Management: Manages relationships with complex provider partnerships to improve value based performance, provider satisfaction and retention.
  • Foster direct collaboration between providers and the health care plan to reduce rework, streamline administration and reduce costs for all constituents.
  • Collaborate with all functions within the company to develop services and processes that streamline claim adjudication, achieve a high level of compliance and customer satisfaction.
  • Lead the development of provider related corporate initiatives, business plans, strategies, and goals.
  • Manage efforts to partner with providers to achieve high quality results consistent with QARR and HEDIS measures.
  • Collaborate with operational areas and appropriate vendors on initiatives that support claim processing and financial efficiencies.
  • Monitor new trends in provider network, reimbursement and services.
  • Design and implement strategies to capitalize on new trends.
  • Enhance and leverage analytics, member demographics, and healthcare facility usage patterns to identify efficiency opportunities and target service providers for direct contracts.
  • Maintain local and state government relationships, including dealing with regulators as necessary to establish and continue effective working relationships.
  • Attract, recruit and retain the talent Provider Relations needs to achieve its objectives.
  • Provide mentoring and foster a success-oriented and accountable culture.
  • Coordinate and Communicate annual Provider Satisfaction Survey consistent with NCQA standards.
  • Provide oversight to internal provider credentialing process, ensuring adherence to credentialing policies and procedures.
  • Collaborate with others on data that impacts provider domain to ensure that provider data is being maintained consistent with internal data governance standards.

Education/Experience: Bachelor's Degree required.
Master's Degree preferred.
9+ years experience in senior leader roles in managed care environment at a Healthcare payer organization required.
Experience focused specifically on developing provider networks and building partnerships preferred.
Highly developed knowledge of healthcare industry, provider network, claim processing, UM guidelines and health plan operations.

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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