Director, Contracting & Network Development

Centene Corporation•Mechanicsburg, PA

5d•$141,500 - $261,400•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 position will oversee activities of the provider contracting, network development and/or provider relations functions and aid 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. It also includes implementing development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions. The role supports new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources. It requires performing complex financial analyses to identify medical cost improvement opportunities, developing strategies to reach financial goals, and executing contracting strategies to meet goals and objectives. The role also involves overseeing contracting and network development staff and external consultants in the development of provider networks for new and expansion markets, monitoring performance, developing and implementing business solutions to address process and quality gaps, and communicating network strategy and planning. Occasional travel is required.

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 Pennsylvania to be considered for this role.

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.