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Centene

Runs government-backed health insurance plans

VP Network Strategy and Management Solutions

Corporate StrategyConfirmed live in the last 24 hours
Full-time$171.9k - $326.9k /yrRemote

About the Job

Requirements

  • A bachelor's degree in Business, Management, Healthcare Administration, or a related field is required, or equivalent experience reflecting the position's applicable knowledge, duties, scope, and skill.
  • At least 10 years of healthcare administration, network development, or provider/payor contracting experience in a healthcare or managed care environment is required.
  • Experience in provider network development and strategy, provider contract negotiations, leading network development staff, and unit cost and network strategy budgeting is required.
  • Previous management experience, including hiring, training, assigning work, and managing staff performance, is required.

Responsibilities

  • Lead strategy development and execution for the growing ICHRA product, including building provider networks with dedicated rates across current and future markets for Centene employees and external members.
  • Expand provider network development and value-based contracting activities.
  • Assist with value-based contracting provider network strategy, including provider contract negotiation, development of new value-based models, driving provider performance related to quality and reduction of avoidable healthcare costs, assisting with preparation for provider performance meetings, and supporting decision-makers with analysis related to historical and projected provider performance.
  • Develop relationships in multiple markets and implement strategies with key providers, provider associations, and provider stakeholders.
  • Lead key provider negotiations with hospitals, physicians, ancillary providers, and community health centers.
  • Develop and implement network development strategy plans with key providers in multiple markets.
  • Oversee the development of provider networks across expansion markets.
  • Manage budgeting and forecasting initiatives for stakeholder/network strategies, product lines, network costs, and/or provider contracts.
  • Develop and coordinate provider advisory boards, committees, and governance, and maintain relationships with key provider leadership.
  • Assist and advise on key provider relations and strategies.
  • Evaluate opportunities to expand or change the network to meet company goals.
  • Perform other duties as assigned and comply with all policies and standards.

Desired Qualifications

  • An MBA is preferred.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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