Centene
health care
VicePresident,NetworkDevelopment&Contracting
Neural analysis suggests this role is
optimal for Senior candidates.
“Vice President, Network Development & Contracting at Centene. Skills: provider network development, contracting management, network strategy, reimbursement and unit cost management. Direct the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management”
What You'll Achieve.
Direct the provider network and contracting activities; Lead all aspects of provider network strategy; support decision makers with analysis related to reimbursement and unit cost management; Oversee the coordination and negotiation for the contracting department; Establish the department’s strategic vision, objectives, and policies and procedures; Develop, implement and maintain production and quality standards for the Contracting department; Oversee network development staff and external consultants in the development of provider networks across expansion markets; Perform periodic analyses of the provider network from a cost, coverage, and growth perspective; Provide leadership in evaluating opportunities to expand or change the network to meet Company goals; Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts; Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations; Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy; Support market expansion and M&A activities by leading provider contract analysis related to due diligence; Assist health plan CEO and/or COO vendors in key provider relations and strategy
Industry & Context.
analysis related to reimbursement and unit cost management; analysis of claim trend data and/or market information to derive conclusions to support contract negotiations; periodic analyses of the provider network from a cost, coverage, and growth perspective
Ability to travel
What They're Looking For.
Must Have
Bachelor's Degree or equivalent experience in Business Administration, Healthcare Administration or related field required, 10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment required, Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
Nice to Have
MBA or MHA degree preferred
What You'll Do.
Direct the provider network and contracting activities
Lead all aspects of provider network strategy including
network operations and support decision makers with analysis related to reimbursement and unit cost management
Oversee the coordination and negotiation for the contracting department
Establish the department’s strategic vision
and policies and procedures
implement and maintain production and quality standards for the Contracting department
Oversee network development staff and external consultants in the development of provider networks across expansion markets
Perform periodic analyses of the provider network from a cost
and growth perspective
Provide leadership in evaluating opportunities to expand or change the network to meet Company goals
Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts
Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations
Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy
Support market expansion and M&A activities by leading provider contract analysis related to due diligence
Assist health plan CEO and/or COO vendors in key provider relations and strategy
How You'll Work.
Team & Collaboration
Oversee network development staff and external consultants; Assist health plan CEO and/or COO vendors in key provider relations and strategy
Full Job Description
Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. **Position Purpose:** Direct the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department. * Establish the department’s strategic vision, objectives, and policies and procedures. * Develop, implement and maintain production and quality standards for the Contracting department. * Oversee network development staff and external consultants in the development of provider networks across expansion markets. * Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. * Provide leadership in evaluating opportunities to expand or change the network to meet Company goals. * Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts. * Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations. * Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy. * Support market expansion and M activities by leading provider contract analysis related to due diligence. * Assist health plan CEO and/or COO vendors in key provider relations and strategy. * Ability to travel. **Education/Experience:** Bachelor's Degree or equivalent experience in Business Administration, Healthcare Administration or related field required. MBA or MHA degree preferred. 10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment required. Previous management experience including responsibilities
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