Senior Manager, Provider Relations

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🔥 9 minutes ago

🏖️ New Jersey, Maryland, +1 more states – Remote

🏖️ New Jersey – Remote 🦀 Maryland – Remote 🔔 Pennsylvania – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟠 Senior

💰 Account Manager

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

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

• Lead a team of Provider Relations Representatives, Network Performance Advisors and/or Provider Relations Supervisors • Manage assigned region and/or market territory • Develop the Provider Relations Team to achieve market performance targets • Implement and execute network transformation strategies to improve overall network performance • Conduct field ride-alongs and provide timely formative feedback through Field Trip Reports • Monitor provider performance action plans and track improvement • Ensure compliance with provider performance and relationship models and provider performance reporting • Partner with the Quality Team to improve provider performance related to HEDIS and STARS measures • Plan and execute effective group meetings and discussions • Ensure adherence to contractual obligations and regulatory requirements • Improve Provider Satisfaction and Provider Experience • Monitor and develop High Performing Practices and drive Network Transformation Strategies to optimize member outcomes • Educate and enhance provider partnerships and implement market and enterprise initiatives • Strategize membership growth for High Performing Practices and complex provider relationships • Train, mentor and guide new managers • Lead and develop Provider Operations staff • Complete special projects as assigned or directed

🎯 Requirements

• Bachelor's Degree in a related field • 6+ years of experience in provider relations or similar background • 3+ years of management experience • Equivalent work experience accepted as an alternative to the required bachelor's degree • Understanding of Risk and Value-Based contractual arrangements • Understanding of HEDIS and STARS measures • Ability to ensure adherence to contractual obligations and regulatory requirements

🏖️ Benefits

• Competitive pay • Health insurance • 401K plans • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity