Director, Contracting & Network Development

Centene Management CompanyClayton, NC
Remote

About The Position

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. This role oversees activities of the provider contracting, network development and/or provider relations functions and aids in formulating and administering organizational policies and procedures. It involves overseeing provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations. The position implements development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions. It supports new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources. The role performs complex financial analyses to identify medical cost improvement opportunities, develops strategies to reach financial goals, and executes contracting strategies to meet goals and objectives. It also oversees contracting and network development staff and external consultants in the development of provider networks for new and expansion markets, monitors performance, develops and implements business solutions to address process and quality gaps, and communicates network strategy and planning. The role requires the ability to travel.

Requirements

  • Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience.
  • 7+ years of combined contracting, network development or provider relations experience.
  • Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements.
  • Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff.
  • Valid driver's license.
  • Applicants must be in the state of Missouri to be considered for this role.

Nice To Haves

  • Ability to travel

Responsibilities

  • Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.
  • Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations.
  • Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
  • Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources.
  • Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives.
  • Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets.
  • Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning.

Benefits

  • competitive pay
  • health insurance
  • 401K
  • stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • a flexible approach to work with remote, hybrid, field or office work schedules
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