Centene Corporation
Healthcare Insurance • Non-profit • Social Impact
Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.
Vendor Management Manager
November 7
Centene Corporation
Healthcare Insurance • Non-profit • Social Impact
Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.
📋 Description
• Manage vendor utilization including workflows for coordinating services with the Illinois Health Plan • Analyze vendor data and complete required reports for the health plan, Corporate and state • Create and manage vendor scorecard and associated ratings/correction plans • Perform as a key account manager for the Illinois Health Plan to coordinate with high priority providers and vendors • Coordinate with Corporate Vendor Management team regarding vendor expectations, performance, and procedures • Coordinate with Medical Management, Member Services and Provider Services to educate and communicate expectations, performance and procedures to vendors • Conduct monthly meetings and document discussions, issues, attendees, action items, research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution • Receive and respond to provider related database information requests and concerns • Ensure operation integrity, including compliance with all policies and procedures for the Illinois Health Plan including adherence to state contracts and guidelines • Request and/or assist in the development of correction action plans for standards that are not met by the vendor
🎯 Requirements
• Bachelor's degree in public health, business or related field or equivalent experience • 4+ years of healthcare management experience, preferably in vendor managed care or the health insurance field • Experience with reporting and analyzing data preferred • Strong Excel skills and working with a variety of software data programs preferred • Project management experience a plus
🏖️ 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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