Centene Corporation
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.
Vice President, Population Health – Clinical Operations
🔥 0 minutes ago
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Centene Corporation
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
• Serve as a key stakeholder, decision maker, and catalyst for market-level population health identification, strategy, evaluation, and monitoring • Provide strategic leadership for population health internally and with providers, community organizations, advocacy groups, and applicable legislature • Analyze the local healthcare landscape to identify drivers and opportunities for innovative Quadruple Aim models • Assess community health needs and population attributes to develop programs and services • Use analytics to identify population insights and develop targeted interventions • Oversee all market utilization management functions, including prior authorization and concurrent review • Orchestrate population health strategy for the business • Drive local HBR initiatives in partnership with Finance • Partner with physicians to translate member needs into intentional clinical program design and successful health outcomes • Liaise with state regulators regarding clinical programs • Coordinate quality initiatives, including audits, star ratings, and contract reviews, and activate enterprise and local policies • Inform and execute contracts, including provider contracts, by driving outcomes and operationalizing them locally • Contribute to enterprise and local committees • Serve as an integral member of the executive leadership team delivering clinical solutions to evolving business needs • Execute standards and customize them to local requirements while partnering with Centers of Excellence to drive continuous improvement through governance and performance monitoring • Perform other duties as assigned and comply with all policies and standards
🎯 Requirements
• Bachelor's Degree required • 5+ years of relevant experience required • Master's Degree preferred • Current state RN license preferred • Ability to lead market-level population health strategy, evaluation, and monitoring • Experience with utilization management functions, including prior authorization and concurrent review • Experience using analytics to identify population health insights and develop interventions • Knowledge of healthcare markets, community health needs, clinical program design, quality initiatives, and contract operationalization • Ability to partner with physicians, providers, Finance, regulators, community organizations, advocacy groups, committees, and executive leadership • Ability to execute standards, customize requirements locally, and drive governance and performance monitoring
🏖️ Benefits
• Competitive pay • Health insurance • 401K plan • 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
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