VBC Performance Manager
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: New York • United States
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Salary
💰 $70,100 - $126,200 per year
About the role
- Develop strategic partnerships between the health plan and contracted provider networks
- Engage with providers to align on network performance opportunities and solutions
- Drive optimal performance in contract incentive performance, quality, and cost utilization
- Participate in the development of network management strategies
- Serve as primary contact for providers and act as liaison ensuring coordinated effort in improving performance
- Investigate, resolve and communicate provider claim issues and changes
- Perform provider orientations and ongoing education
- Evaluate provider performance and develop strategic plans for improvement
- Present detailed HBR analysis and create reports for Joint Operating Committee meetings
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, or 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 & Tools
HEDISquality measurescost utilizationprovider relationsclaims managementcontractingutilization managementclinical operationsproject managementnetwork management strategies
Soft Skills
communication skillspresentation skillsinterpersonal skillsproblem-solvingstrategic planningcollaborationeducation and trainingperformance evaluationliaison skillsanalytical skills
Certifications
Bachelor's degree