As a rapidly-growing company changing the world, Centene champions affordable best-in-class health options for our millions of members. By offering unique, highly personalized and, most importantly, cost-effective solutions for the underserved, we transform the health of the community one person at a time. And for our employees, we offer more than a job: we offer a purpose.
Design, implement, and optimize innovative and value based payment contracting strategies to include the development of a broad vision, short and long term objectives and execution of key business initiatives across all products. Collaborate with multiple functional health plan departments to build out a strategic payment innovation roadmap. Using the newly developed roadmap, lead implementation of prioritized initiatives in partnership with Provider Network Management, Medical Management, Product, Claims, Sales and Marketing, Finance and Actuarial teams.
Leads provider innovation, provider initiatives and network strategy, including network provider pricing and cost optimization, trend analysis and provider network improvement opportunities.
Leads the identification, development, work process design and implementation of new network provider innovation models.
Researches Federal, State and competitor strategies on value-based payments. Attend conferences and other events to ensure the business is fully aware of payment innovation efforts on all levels.
Develops and implements provider network innovation and optimization standards and guidelines to increase market share, revenue growth, and quality outcomes.
Develops, implements and maintains a multi-year strategic roadmap for the company’s value-based payments strategy.
Leads a cross-functional team and work across the health plan to implement targeted initiatives (bundled payments, hospital quality incentives, shared risk redesign).
Works with key stakeholders to understand and translate external strategies and requirements into internal implementation plans.
Collaborates with Networks team on payment innovation work and become the California health plan voice on various corporate committees and initiatives related to payment innovation strategy.
Oversees new provider innovation projects and program initiatives, including staff allocation, deliverables, milestones, and goals.
Identifies best practice and “center of excellence” opportunities and implement best practice approach to new providers through provider education.
Education & Experience Requirements:
Bachelors’ degree in a related field or equivalent experience
Master’s degree preferred
7+ years of contracting, network development, or provider network strategy or analysis experience in a healthcare or managed care environment
Experience in developing and executing multiyear roadmaps, evaluating various value based programs
Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff
Project/Program management experience
PMP Certification preferred
Interested and qualified candidates should send their a copy of their resume to Robert Konrady at RKonrady@Centene.com.
Additional Salary Information: Determined by experience.
Internal Number: 1088376
About Centene Corporation
When you join Centene, you’re joining a team of focused, driven individuals all working together to serve the underserved. We assist more than 12 million members through government-sponsored healthcare programs, focusing on the under-insured and uninsured. In our fast-paced and ever-changing environment, we share an unwavering commitment to helping those who need it the most by working tirelessly to improve health outcomes.