Vice President, Provider Networks

Centene Corporation Rancho Cordova, CA

The Vice President, Provider Network Management (Federal Services) is accountable for the strategic direction, performance results, and the development and management of provider networks to support multiple large-scale federal government programs. The role will lead all aspects of outcomes based network growth strategy including, but not limited to a national contracting strategy, innovative value based contracts, and risk sharing models.


  • Develop provider network strategies that support multiple large scale government programs. Lead the development of network strategies and reimbursement models to align incentives with provider performance.
  • Manage the strategic development of national and regional networks that support program specific performance standards and business goals. Accountable for ensuring network composition includes appropriate distribution of provider specialties to achieve network adequacy requirements.
  • Drive cost effective strategies including the management and negotiation of value based contracts. Conduct regular review of contracting rates to ensure cost strategy is on target
  • Responsible for the overall performance including network effectiveness, cost containment, quality outcomes and provider satisfaction and engagement. Drive critical network development initiatives or analysis requiring collaboration with other functional areas including but not limited to medical management, data analytics, finance, or other program management.
  • Develop and deliver comprehensive and value-add education and communication to provider partners and internal stakeholders to effectively execute strategic objectives.
  • Assess and develop a plan to address existing technology enablers to identify gaps and opportunities to develop approaches toward improving the overall delivery system

 

Education/Experience:

Bachelor’s degree in Business Administration, Healthcare Administration, or related field required; MBA preferred.


10+ years’ experience in managed care network development and provider relations/contracting strategy, negotiation and management in a large healthcare and/or managed care environment required. 3+ years of management experience required. Ability to think strategically and drive complex strategies in an ambiguous and evolving healthcare environment; strong influencing and negotiation skills; leader with experience transforming a team in a dynamic health care environment preferred.


The ability to travel up to 40% is required. 


Role can be remote

Government Security/Clearance/Citizenship Requirements: Requires US citizenship and current security clearance


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.

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