Centene
healthcare
VicePresident,PopulationHealth&ClinicalOperations
Neural analysis suggests this role is
optimal for Senior candidates.
“Vice President, Population Health & Clinical Operations at Centene. Skills: process management, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement, medical management, quality improvement. Plan, develop, and drive execution of medical management and quality improvement programs, processes, and initiatives. Ensure improved quality outcomes, achievement of health benefit ratio targets, and reduction in administrative costs”
What You'll Achieve.
improved quality outcomes; achievement of health benefit ratio targets; reduction in administrative costs; increase effectiveness and efficiency
Industry & Context.
reduction in administrative costs; improve quality outcomes
Approximately 50% travel
What They're Looking For.
Must Have
Bachelor's Degree in business or healthcare related field, 10+ years of experience working in a complex healthcare setting, Expert understanding of Managed Care practices including utilization management, care management, clinical information systems, with financial acumen and focus, preferably in the governmental setting, Proficient in the use of project management tools, Application of continuous process improvement methodologies such as Lean, Six Sigma or equivalent
Nice to Have
Master's Degree strongly preferred, Six Sigma certification strongly preferred
What You'll Do.
and drive execution of medical management and quality improvement programs
Ensure improved quality outcomes
achievement of health benefit ratio targets
and reduction in administrative costs
Drive adoption of best practices and standardization
Develop customized approaches for unique markets and product lines
Oversee corporate accreditation
medical management operations and new business development and implementation
Define medical management and quality improvement strategic and operating plans
Collaborate to evaluate medical trends and develop medical management and quality improvement initiatives
and execution of standardized initiatives and best practices
Facilitate mechanisms to utilize pilots
and identify best practices
Oversee the development and implementation of medical management policies and procedures
Develop and implement business plans to leverage technology to increase effectiveness and efficiency
Develop and implement standardized training
Develop and implement standardization in measuring and monitoring operational and outcome metrics
Facilitate integration and collaboration between the Health Plans and Specialty Companies related to medical management and quality improvement initiatives
How You'll Work.
Team & Collaboration
Collaborate to evaluate medical trends; Facilitate integration and collaboration between the Health Plans and Specialty Companies
Process & Methodology
project management tools, planning, developing, driving execution, strategic and operating plans
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:** Plan, develop, and drive execution of medical management and quality improvement programs, processes, and initiatives to ensure improved quality outcomes, achievement of health benefit ratio targets, and reduction in administrative costs. Drive adoption of best practices and standardization, while developing customized approaches for unique markets and product lines. Oversee corporate accreditation, quality improvement, medical management operations and new business development and implementation. * Define medical management and quality improvement strategic and operating plans, balancing standardization with market or product specific solutions. * Collaborate to evaluate medical trends and develop medical management and quality improvement initiatives to improve quality, achieve health benefit ratio targets, and reduce administrative costs. * Drive discipline, consistency, and execution of standardized initiatives and best practices. * Facilitate mechanisms to utilize pilots, measure results, and identify best practices to be used across health plans. * Oversee the development and implementation of medical management policies and procedures to ensure NCQA and URAC standards. * Develop and implement business plans to leverage technology to increase effectiveness and efficiency. * Develop and implement standardized training, auditing, and work processes for new and existing business to ensure consistency and avoid redundant efforts. * Develop and implement standardization in measuring and monitoring operational and outcome metrics. * Facilitate integration and collaboration between the Health Plans and Specialty Companies related to medical management and quality improvement initiatives. * Approximately 50% travel. **Education/Experience:** Bachelor's Degree in business o
Applying for this Vice President, Population Health & Clinical Operations role?
Most applicants get filtered before a human reads their resume. See if yours makes the cut.
How to Apply on Workday
- Workday has a multi-step form — save your progress after every section.
- "Apply With LinkedIn" can fail or lose data; manual entry is more reliable.
- Watch for the "Submit for Review" final step — hitting "Save" alone does not submit.
- Job requisition numbers are useful when following up with HR by email.
ANONYMOUS · UNFILTERED
What do employees actually say about Centene?
Real rants from real employees. Read before you apply.