Senior Manager, Provider Relations

Centene Corporation•Remote-DE, MD

7d•$87,700 - $157,800•Hybrid

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 leads a team of Provider Relations Representatives, Network Performance Advisors and/or Provider Relations Supervisors to effectively manage an assigned region and/or market territory. The goal is to develop the Provider Relations Team to achieve market performance targets through the implementation and execution of network transformation strategies to improve overall Network Performance. Candidates must reside in DE, MD, NJ or PA.

Requirements

A Bachelor's Degree in a related field
6+ years of experience in provider relations or similar background
3+ years of management experience

Responsibilities

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.
Leads and develops Provider Operations staff.