Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Director, Provider Network Performance

DirectorDirectorFull TimeRemoteTeam 10,001+Since 1984H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

27 days ago

Salary

$118.4K - $219K / year

Bachelor Degree7 yrs expEnglish

Job Description

• Oversee efforts to improve provider network performance and promote provider engagement. • Oversee the planning and operations of all activities related to provider network performance. • Collaborate with health plans and various stakeholders to develop overall plan for improving provider performance. • Develop effective training and communication tools and processes related to provider network performance. • Provide direction to determine company-wide analytic reporting needs and provide training and support on network performance applications and reporting tools. • Collaborate with health plan leaders and providers to review network performance, including quality, cost, care gaps, and risk adjustment gaps, and develop improvement plans. • Oversee provider profiling and network performance analytic support functions and provide support to health plans and other stakeholders. • Oversee the evaluation of provider Health Benefits Ratio (HBR), quality, unit cost and utilization trends and identify and implement network improvement opportunities. • Oversee the support and improvements of existing application tools to enhance outcomes and functionality.

Job Requirements

  • Bachelor’s degree in Business, Economics, Finance, Healthcare or related field.
  • 7+ years of contracting, health care reimbursement, provider contract modeling or quality measurement experience.
  • Prior experience building and managing relationships with health care providers preferred.

Benefits

  • 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

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