Vice President, Network Development & Contracting

at Centene Corporation in Burr Ridge, Illinois, United States

Job Description

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose: Direct the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department.

Establish the department’s strategic vision, objectives, and policies and procedures.

Develop, implement and maintain production and quality standards for the Contracting department.

Oversee network development staff and external consultants in the development of provider networks across expansion markets.

Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.

Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.

Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.

Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.

Support market expansion and M&A activities by leading provider contract analysis related to due diligence.

Assist health plan CEO and/or COO vendors in key provider relations and strategy.

Ability to travel.

Education/Experience: Bachelor’s degree or equivalent experience in Business Administration, Healthcare Administration or related field. MBA or MHA degree preferred. 10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

Preferred Experience: Medicaid, Medicare and Commercial contracting

License/Certification: Valid driver’s license.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

TITLE: Vice President, Network Development & Contracting

LOCATION: Burr Ridge, Illinois

REQNUMBER: 1448241

Copy Link

Job Posting: JC247377499

Posted On: Sep 08, 2023

Updated On: Nov 03, 2023

Please Wait ...