Performance Manager
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Florida • Illinois • United States
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Salary
💰 $70,100 - $126,200 per year
About the role
- Develop strategic partnerships between the health plan and the contracted provider networks
- Engage with providers to align on network performance opportunities
- Consultative account management and accountability for issue resolution
- Drive optimal performance in contract incentive performance, quality, and cost utilization
- Participate in the development of network management strategies
- Assist in the strategic implementation of new initiatives for performance improvement
- Serve as primary contact for providers
- Act as a liaison between the providers and the health plan
- Identify and deliver solutions to providers concerns and issues as needed
- Investigate, resolve and communicate provider claim issues
- Engage with and educate providers regarding policies and procedures
- Perform provider orientations and ongoing provider education
- Manages Network performance for assigned territory
- Evaluates provider performance and develops strategic plan to improve performance
- Drives provider performance improvement in various areas
- Present detailed HBR analysis and create reports for Joint Operating Committee meetings
- Develop proficiency in tools and educate providers on use of tools
Requirements
- Bachelor’s degree in related field or equivalent experience
- Three or more years of managed care or medical group experience
- provider relations
- quality improvement
- claims
- contracting
- utilization management
- clinical operations
- Project management experience at a medical group, IPA, or health plan setting
- Strong communication and presentation skills
- Proficient in HEDIS/Quality measures, cost and utilization.
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
managed careprovider relationsquality improvementclaimscontractingutilization managementclinical operationsproject managementHEDIScost and utilization
Soft skills
strong communication skillspresentation skillsconsultative account managementissue resolutionstrategic thinkingeducational skillsliaison abilitiesperformance improvementproblem-solvingrelationship management
Certifications
Bachelor’s degree