Vice President, Marketplace Network Strategy & Management

Executive Provider Network Strategy

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. Applicants for this role will have the flexibility to work remotely anywhere in the Continental United States.

Position Purpose : Responsible for developing and managing the provider network strategy for Centene Corporation. Lead all aspects of provider network strategy including, but not limited to reimbursement strategy, contracting strategy, unit cost management, claims configuration and network operations.

• Oversee network development staff and external consultants in the development of provider networks across expansion markets.
• Lead health plans in periodic analyses of their provider networks from a cost, coverage, and growth perspective.
• Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
• Manage budgeting and forecasting initiatives for product lines to network costs and provider contracts.
• Oversee analysis of claim trend data and / or market information to derive conclusions to support contract negotiations.
• Lead initiatives to ensure periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
• Lead development of fee schedules and rates for new and existing markets consistent with budget and premium revenue assumptions (includes physicians, hospitals and ancillaries). Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
• Assist health plan CEOs, network development, legal and finance teams in key provider contract negotiations and strategy.
• Work collaboratively with Business Development on new market and new product development initiatives.
• Ability to travel.
• For Business Development Only :
• Develop relationships on both a national level and in multiple markets, implementing strategies with administration and organizational leadership of key provider (trade) associations, key providers and provider stakeholders and specifically including but not limited to; those associations, providers, organizations and stakeholders identified as part of the National Association of Community Health Clinics, Primary Care Associations, Federally Qualified Health Clinics, Rural Health Clinics and 340(b) Pharmacies;.
• Organize and facilitate participation in association conferences on national and state level as is appropriate and collaborate with franchise health plans and other functional units to participate as well as to improve upon relationships and network development.

Education / Experience :

Pay Range : $223,200.00 - $422,900.00 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