Director, Provider Network Performance
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $118,400 - $219,000 per year
Job Level
About the role
- Oversee efforts to improve provider network performance and promote provider engagement.
- Oversee the planning and operations of all activities related to provider network performance.
- Collaborate with health plans and various stakeholders to develop overall plan for improving provider performance.
- Develop effective training and communication tools and processes related to provider network performance.
- Provide direction to determine company-wide analytic reporting needs and provide training and support on network performance applications and reporting tools.
- Collaborate with health plan leaders and providers to review network performance, including quality, cost, care gaps, and risk adjustment gaps, and develop improvement plans.
- Oversee provider profiling and network performance analytic support functions and provide support to health plans and other stakeholders.
- Oversee the evaluation of provider Health Benefits Ratio (HBR), quality, unit cost and utilization trends and identify and implement network improvement opportunities.
- Oversee the support and improvements of existing application tools to enhance outcomes and functionality.
Requirements
- Bachelor’s degree in Business, Economics, Finance, Healthcare or related field.
- 7+ years of contracting, health care reimbursement, provider contract modeling or quality measurement experience.
- Prior experience building and managing relationships with health care providers preferred.
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 & Tools
provider network performanceanalytic reportingprovider contract modelingquality measurementhealth care reimbursementdata analysisperformance improvementtraining developmentcommunication toolsnetwork performance applications
Soft Skills
collaborationrelationship managementleadershipcommunicationorganizational skillsproblem-solvingstakeholder engagementtraining and supportdirection providingevaluation