Vice President, Retrospective Programs

🕒 August 19

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $188.9k - $359.8k / year

⏰ Full Time

🔴 Lead

👔 Vice President

👻 Ghost score 47%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 the enterprise retrospective program strategy and execution model • Establish and maintain an end-to-end operating model defining roles, accountabilities, performance expectations, escalation paths, and decision rights • Oversee chart retrieval operations for targeted, timely, and complete medical record collection • Drive retrieval and coding vendor oversight, including production performance, coding accuracy, quality monitoring, contract deliverables, service-level agreements, issue resolution, corrective action plans, and continuous improvement • Lead coding quality assurance programs, including second-level review, quality sampling, trend analysis, and remediation of coding defects or documentation gaps • Partner with Analytics on retrospective analytics, vendor performance insights, opportunity identification, forecasting, operational dashboards, and performance reporting • Serve as business lead for vendor strategy, vendor consolidation, strategic partner evaluation, cost optimization, capacity planning, contract negotiation and performance, and procurement liaison activities • Represent retrospective programs in enterprise governance forums • Translate operational, coding, claims, and analytics information into executive-level insights, decisions, and action plans • Collaborate with Claims, Encounters, Data Integrity, Compliance, Finance, Provider Engagement, local markets, Network, and Technology • Develop and lead a high-performing team focused on accuracy, compliance, transparency, collaboration, and continuous improvement

🎯 Requirements

• Bachelor's degree in Healthcare Administration, Business, Finance, Clinical Discipline, Health Information Management, Analytics, or related field required • 10+ years of progressive healthcare leadership experience, including risk adjustment, provider engagement, clinical documentation improvement, quality, claims, vendor management, or related healthcare operations required • Experience leading enterprise programs across multiple markets and lines of business required • Demonstrated success leading strategic initiatives, provider-facing programs, vendor partnerships, and cross-functional teams required • Strong knowledge of risk adjustment methodologies, healthcare operations, provider documentation, and regulatory requirements required • Proven executive leadership, communication, and stakeholder management skills required • Equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position • 10+ years experience in operations leadership, retrospective programs, coding, chart retrieval, or quality data integrity preferred • Experience leading Risk Adjustment functions across multiple markets and multiple lines of business (Medicare, Marketplace, Medicaid) preferred • National payer experience preferred

🏖️ 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 • Equal opportunity employer committed to diversity