Vice President, Network Strategy – Management Value-Based Contracting

🕒 Junho 4

🏰 Missouri, Texas – Remoto

🏰 Missouri – Remote 🤠 Texas – Remote

💵 $227.700 - $431.400 / 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

• Responsible for developing and managing the provider network strategy for Centene Corporation • Lead all aspects of provider network strategy including reimbursement strategy, contracting strategy, unit cost management, claims configuration and network operations • Oversee network development staff and external consultants in the development of provider networks across expansion markets • Lead health plans in periodic analyses of their provider networks 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 network costs and provider contracts • Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations • Lead initiatives to ensure periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy • Lead development of fee schedules and rates for new and existing markets consistent with budget and premium revenue assumptions • Support market expansion and M&A activities by leading provider contract analysis related to due diligence • Assist health plan CEOs, network development, legal and finance teams in key provider contract negotiations and strategy • Work collaboratively with Business Development on new markets and new product development initiatives • Ability to travel • Performs other duties as assigned

🎯 Requisitos

• Bachelor’s degree in business administration, healthcare administration or related field required • MBA or MHA degree preferred • 10+ years of experience in managed care network development • 3+ years of experience in government programs • Demonstrated success leading large‑scale, multi‑market VBC programs across Medicaid, Medicare (including MA/D‑SNP), and/or commercial markets preferred • Previous experience managing staff, including hiring, training, managing workload and performance • Valid driver's license

🏖️ 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