You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Please note: candidates must reside in DE, MD, NJ or PA.
Position Purpose: Leads team of Provider Relations Representatives, Network Performance Advisors and/or Provider Relations Supervisors to effectively manage assigned region and/or market territory. Develops Provider Relations Team to achieve market performance targets through the implementation and execution of network transformation strategies in order to improve overall Network Performance. Candidate Education: Required A Bachelor's Degree in a related field
- Leads and develops a team of Provider Relations Representatives, Provider Relations Supervisors and/or Network Performance Advisors.
- Conducts ride-alongs with Reps in the field to develop skills and behaviors and document progress/provide formative feedback through timely and consistent Field Trip Reports.
- Identifies team skill set deficiencies and implements proper professional development plans.
- Monitors Provider Performance action plans and tracks provider performance improvement.
- Ensures compliance with enterprise provider performance and relationship model and team engagement of provider performance reporting.
- Responsible for understanding the differences between Risk and Value-Based contractual arrangements.
- Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive improvement of quality provider performance.
- Plans, prepares and executes effective group meetings/discussions with proper objectives and outcomes.
- Ensures adherence to contractual obligations and to regulatory requirements.
- Identifies areas of opportunity to improve Provider Satisfaction and Provider Experience.
- Assists in monitoring and developing High Performing Practices and driving Network Transformation Strategies to optimize member outcomes.
- Educates and enhances provider partnerships and implements market and enterprise initiatives.
- Strategizes membership growth for High Performing Practices and/or sophisticated complex provider relationships.
- Provides training, mentoring and guidance to new managers.
- Special projects as assigned or directed.Additional Responsibilities: * Leads and develops Provider Operations staff.
Required or equivalent work experienceCandidate Experience: Required 6+ years of experience in provider relations or similar background
Required 3+ years of management experience
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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