Vice President, Network Strategy – Management Value-Based Contracting

🕒 il y a 2 jours

🏰 Missouri, Texas – Distant

🏰 Missouri – Remote 🤠 Texas – Remote

💵 $227 700 - $431 400 / an

⏰ Temps Plein

🔴 Expert

👔 Vice-président

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Centene Corporation

Site WebLinkedInTous les Emplois

10 000+ employés

Fondée en 1984

⚕️ Assurance santé

🤝 À but non lucratif

🌍 Impact social

Healthcare Insurance • Non-profit • Social Impact

La société Centene Corporation est un leader dans la fourniture de services de santé subventionnés par le gouvernement, spécialisée dans la délivrance de solutions de santé abordables et de haute qualité. Depuis plus de 40 ans, Centene s’est concentrée sur la transformation de la santé des communautés en élargissant l'accès aux services de Medicaid, Medicare, et au marché de l'assurance santé, tout en servant les communautés militaires à travers le programme TRICARE. En tant que plus grande organisation de gestion des soins Medicaid et un acteur clé du marché, Centene met l'accent sur une prestation de soins de santé localisée combinée à des partenariats solides avec des organisations à but non lucratif pour répondre aux besoins uniques de ses membres. Centene s’engage également pour le développement durable et la responsabilité sociale des entreprises, en privilégiant la gestion environnementale et la gouvernance éthique afin d'améliorer le bien-être des communautés qu’elle dessert.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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