Vice President, Network Development – Contracting

🕒 Maio 19

🚗 Michigan – Remoto

🚗 Michigan – Remote

💵 $180.400 - $343.300 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Vice-presidente

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Centene Corporation

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1984

⚕️ Seguro de Saúde

🤝 Sem Fins Lucrativos

🌍 Impacto Social

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation é uma provedora líder de serviços de saúde patrocinados pelo governo, especializada em oferecer soluções de saúde acessíveis e de alta qualidade. Há mais de 40 anos, a Centene tem se dedicado a transformar a saúde das comunidades, ampliando o acesso a Medicaid, Medicare e ao Health Insurance Marketplace, além de atender comunidades militares por meio do programa TRICARE. Como a maior organização de managed care do Medicaid e participante-chave no Marketplace, a Centene enfatiza a entrega de cuidados de saúde com foco local, combinada a parcerias sólidas com organizações sem fins lucrativos para atender às necessidades únicas de seus membros. A Centene também é comprometida com sustentabilidade corporativa e responsabilidade social, priorizando a gestão ambiental e a governança ética para promover o bem-estar das comunidades que atende.

Descrição

• Direct the provider network and contracting activities • Lead all aspects of provider network strategy including, access analysis, network operations • 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

🎯 Requisitos

• Bachelor's Degree or equivalent experience in Business Administration, Healthcare Administration or related field required • 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 required • Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff

🏖️ Benefícios

• 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