Back to feed

Senior Director, Value Based Performance Management

Remote Full-time Live

You could be the one who changes everything for our 28 million members. 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.

Highly preferred that candidate resides in the Chicago, IL market.

* Position Purpose: Creates and implements Network Transformation initiatives across a market. Develops Provider Relations Management team to effectively achieve market targets while collaborating with internal departments to drive improvement of provider performance. Candidate Education: Required A Bachelor's Degree in a related field.

  • Leads and develops team of Provider Relations Managers and/or Network Performance advisors to meet/exceed provider performance and provider satisfaction key metrics.
  • Conducts field rides with Provider Relations Representatives to gauge their performance and provide coaching and development in order to improve the business results.
  • 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.
  • Drives improvement of provider performance by analyzing, interpreting and communicating financial, utilization and quality metrics.
  • Establishes and leads collaborative effort with internal cross-functional market and shared services departments to support provider performance and resolve network and operational barriers/challenges.
  • Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive improvement of quality provider performance.
  • Responsible for understanding the differences between Risk and Value-Based contractual arrangements.
  • Plans, prepares and executes effective group meetings/discussions with proper objectives and outcomes.
  • Plans, conducts and directs provider contractual terms and provider account management.
  • Assists in monitoring and developing High Performing Practices and drives Network Transformation Strategies to optimize member outcomes.
  • Strategizes membership growth and retention for High Performing Practices, sophisticated and/or complex Provider Partnerships.
  • Maintains compliance for State and CMS audits.
  • Resolves high level, complex provider issues.
  • Member of state senior leadership team.
  • Special project as assigned or directed.

Candidate Experience: Required 8+ years of experience in provider relations experience Required 5+ years of management experience Pay Range: $148,000.00 - $274,200.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply tot his job Apply To this Job

On the same wavelength

Perinatal Medical Director (Based in MS)

Remote Full-time

Principal Business Strategy – Enterprise Transformation Office Dallas, Texas

Remote Full-time

Entry Level Software Developer with cloud (AWS/AZURE)

Remote Full-time

Azure Platform Architect at Illinois Full time

Remote Full-time

[Remote] Azure Integration Services (AIS) Architect - Milwaukee, WI / Remote

Remote Full-time

B2B Health Plan Marketing Director - remote opportunity

Remote Full-time

Director, B2B Marketing

Remote Full-time

Staff Backend Engineer - Grafana k6 | USA | Remote

Remote Full-time

Transition of Care Nurse - Remote AZ

Remote Full-time

Union Benefit Consultant REMOTE ONLY

Remote Full-time

Experienced Part-Time Evening Remote Data Entry Specialist – Flexible Scheduling for a Dynamic arenaflex Team

Remote Full-time

Senior Software Engineer, Core Experiences - Jakarta, Indonesia

Remote Full-time

Experienced Remote Data Entry Specialist – E-commerce Product Listing and Management with arenaflex

Remote Full-time

Experienced Remote Data Entry Specialist – Live Chat Support and Customer Service Excellence for arenaflex

Remote Full-time

Experienced Full Stack Customer Service Representative – Remote Customer Support and Product Assistance for Global Technology Leader

Remote Full-time

Pharmacy Technologist - Center for Polar Medical Operations (CPMO), 6-9 Months Locum Work - ANTARCTICA

Remote Full-time

[Remote] Genetic Counselor Assistant I, Patient Counseling

Remote Full-time

Youtube Narrator - Contract to Hire

Remote Full-time

Equity Research Analyst, Value, Consumer

Remote Full-time

Immediate Hiring: Require Adjunct - Theater Program in

Remote Full-time