Full-Time

Vice President

Population Health & Clinical Operations

Confirmed live in the last 24 hours

Centene

Centene

10,001+ employees

Provides health insurance and services

Healthcare

Compensation Overview

$173.7k - $329.8kAnnually

Senior, Expert

Detroit, MI, USA

Category
Healthcare Administration & Support
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Required Skills
Data Analysis

You match the following Centene's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • Masters Degree or other advanced degree in Nursing, Social Work, Health Services research, health policy, information technology or other relevant field.
  • Bachelor's degree with 5+ years of relevant experience.
  • Previous experience in a managed care organization strongly preferred.
  • 3+ years of leadership experience.
  • Current state RN license preferred.
Responsibilities
  • Provide strategic leadership for population health internally, as well as with providers, community organizations, advocacy groups, and applicable legislature.
  • Understand the local healthcare landscape to look for key drivers & opportunities for innovative models targeting the Quadruple Aim.
  • Understand the unique community health needs and the attributes of the populations served to drive development of programs and service.
  • Uses analytics to identify key insights about the populations served and drive the development of the interventions to target unique populations.
  • Oversees performance of all UM functions (prior authorization, concurrent review) for the market per the defined partnership agreement.
  • Orchestrates all elements of the population health strategy for the business.
  • Drives HBR initiatives locally through strong partnership and routine with Finance.
  • Partners with MDs to translate the needs of the members into intentional clinical program design that delivers successful health outcomes.
  • Liaises with state regulators for clinical programs.
  • Coordinates quality initiatives (audits, star ratings, contract reviews, etc) and activate enterprise and local policies.
  • Informs and executes against contracts (including provider contracts) – driving outcomes captured in contract and operationalizing locally.
  • Contributing member of enterprise and local committees.
  • Serves as an integral member of the executive leadership team, charged with delivering clinical solutions to evolving business needs.
  • Executes on standards and customizing per local requirements while partnering with the COEs to drive continuous improvement through governance and performance monitoring.
Desired Qualifications
  • Master's Degree preferred.

Centene Corporation operates in the healthcare industry, focusing on improving the health of individuals, especially those who are underinsured or uninsured. The company provides a variety of health insurance products and services, including medical, dental, vision, behavioral health, and pharmacy benefits. Centene's approach is localized, allowing it to tailor its services to meet the specific needs of different communities across the United States. This strategy sets it apart from competitors by ensuring that care is relevant and accessible to its members. The company generates revenue primarily through premiums collected from its 27.5 million members, aiming to deliver high-quality and cost-effective healthcare solutions. Centene is also dedicated to corporate sustainability, addressing social health barriers, and promoting employee well-being through flexible work arrangements.

Company Size

10,001+

Company Stage

IPO

Total Funding

N/A

Headquarters

Saint-Louis, Senegal

Founded

1984

Simplify Jobs

Simplify's Take

What believers are saying

  • Centene's ICHRA plans offer flexibility and choice in health insurance options.
  • Mobile health clinics improve healthcare access in underserved areas, especially for students.
  • Superior HealthPlan's family-friendly policies attract and retain talent in the healthcare sector.

What critics are saying

  • Cybersecurity violations have led to significant financial penalties for Centene.
  • Ongoing legal issues related to False Claims Act violations pose financial liabilities.
  • Rapid growth in Medicare PDP and Marketplace segments may strain operational capacity.

What makes Centene unique

  • Centene's localized approach tailors healthcare services to specific community needs.
  • The company offers a wide range of health insurance products and services.
  • Centene focuses on cost-effective, high-quality care to improve health outcomes.

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Benefits

Health Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Vacation

Hybrid Work Options

Flexible Work Hours

Company News

Sacramento Bee
Feb 18th, 2025
Rancho Cordova subsidiary to pay $11.25M after government alleges cybersecurity flaws

Centene acquired the subsidiary's parent company, Health Net, in a $6 billion deal in 2016.

U.S. Department of Justice
Feb 18th, 2025
Health Net Federal Services, LLC and Centene Corporation Agree to Pay Over $11 Million to Resolve False Claims Act Liability for Cybersecurity Violations

Health Net Federal Services, LLC and Centene Corporation agree to pay over $11 million to resolve false Claims Act liability for cybersecurity violations.

PR Newswire
Feb 14th, 2025
California Students Build A Culture Of Belonging Through National No One Eats Alone® Day Thanks To Health Net The Centene Foundation

More than 1.5 million students nationwide to participate in this year's eventSACRAMENTO, Calif., Feb. 14, 2025 /PRNewswire/ -- Health Net, one of California's most experienced Medi-Cal managed care health plans and company of Centene Corporation (NYSE: CNC), is proud to support No One Eats Alone® Day, a prevention initiative aimed at fostering inclusion to end social isolation and help students get to know one another, so that every student feels like they belong. California schools will host events, with the help of Health Net. National No One Eats Alone Day is February 14, 2025. Centene Foundation, the philanthropic arm of Centene Corporation, sponsors the events."It's our mission to transform the health of the community and that means caring for California's most vulnerable residents, which includes our youth," said Dorothy Seleski, senior vice president for Medi-Cal at Health Net. "We are honored to support No One Eats Alone Day and its mission to end social isolation

PR Newswire
Feb 13th, 2025
Superior Healthplan Recognized As A Best Place For Working Parents® In Texas

Superior's family-friendly policies include workplace flexibility, parental and caregiver leave, and adoption assistance.AUSTIN, Texas, Feb. 13, 2025 /PRNewswire/ -- Superior HealthPlan ("Superior"), a leading managed care organization in Texas and a company of Centene Corporation (NYSE: CNC), announced it has been named a Best Place for Working Parents® for a fifth consecutive year. This designation is supported by Early Matters Greater Austin, a joint initiative from United Way for Greater Austin and E3 Alliance."Supporting working parents with family-friendly resources, policies, and benefits, continues to be a priority for our organization," said Mark Sanders, Superior HealthPlan president and CEO. "This designation signifies our commitment to that approach, one that I believe allows us to elevate our ability to provide quality healthcare to the nearly two million people we serve across Texas."In 2019, Superior was one of the first organizations in Austin to be recognized as a Family-Friendly Workplace. Ever since, Superior has been named a Best Place for Working Parents®, adding multiple benefits aimed at further supporting employees:Parental & Caregiver Leave. Introduced in 2023, this expanded benefit allows employees who give birth up to 14 weeks of parental leave – fully paid – and up to 6 weeks of paid leave to care for a child, spouse, domestic partner, or parent.Introduced in 2023, this expanded benefit allows employees who give birth up to 14 weeks of parental leave – fully paid – and up to 6 weeks of paid leave to care for a child, spouse, domestic partner, or parent

PR Newswire
Feb 11th, 2025
'Ohana Health Plan And The Centene Foundation Award Grant To Hawai'I Island Community Health Center To Expand Healthcare Access

The $550,000 grant will fund a mobile health clinic for underserved studentsKAILUA-KONA, Hawai'i, Feb. 11, 2025 /PRNewswire/ -- 'Ohana Health Plan, a leading provider of government-sponsored managed care services in Hawai'i and the Centene Foundation, the philanthropic arm of Centene Corporation (NYSE: CNC), announced today a $550,000 grant award to Hawai'i Island Community Health Center (HICHC), a nonprofit community health center supporting lifelong health and wellness through quality healthcare. The grant will expand access to essential health services for students in underserved areas. Over two years, funds will support HICHC's "Gateway to Health" project, providing a new mobile health clinic to expand school-based health services for children in rural Hawai'i Island