Vice President, Network Strategy & Management, Value-Based Contracting

🔥 3 hours ago

🏰 Missouri, Texas – Remote

🏰 Missouri – Remote 🤠 Texas – Remote

💵 $227.7k - $431.4k / year

⏰ Full Time

🔴 Lead

👔 Vice President

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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

• 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 • Comply with all policies and standards

🎯 Requirements

• 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

🏖️ 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