Manager, Provider Network Performance.

Posted:
10/24/2024, 5:00:00 PM

Location(s):
North Carolina, United States ⋅ Emilia-Romagna, Italy ⋅ Florida, United States

Experience Level(s):
Senior

Field(s):
IT & Security

Workplace Type:
Hybrid

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Manage and support the development of network performance analytic function. Design and build solutions that create, maintain, interface, or transform data in order to support a complete business need around contracting analytics and modeling applications. Provide analytic support for network performance, unit cost trend, network profiling, evaluation, and contract modeling for current and future business.

  • Lead the development of project applications and determine the financial impact of contract negotiations for health plans, national contracting opportunities (hospital, physician, and ancillary) and statewide rate changes
  • Collaborate with Health Plans to determine analytic reporting needs and provide training and support on network performance applications and reporting tools
  • Lead provider profiling and network performance analytic support function and provide support to health plans and other stakeholders
  • Develop enhanced analytic and reporting capabilities and tools to monitor and evaluate financial impact of changes in unit cost and cost of care
  • Lead the development of network performance management reports to monitor and measure unit cost trends and network improvement opportunities
  • Support existing application solutions, identify and develop technical enhancements to improve outcomes
  • Plan, manage, analyze, design and implement projects, including scheduling deliverables, goals, and milestones
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Bachelor's degree in Business, Economics, Finance, Healthcare or related field. 5+ years of contracting, health care reimbursement, provider contract modeling or quality measurement experience. Knowledge of Health Care Delivery Systems and familiarity with programs such as SQL, SAS/SPSS, Office Suite, and Visio. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

This position is open to someone working remotely anywhere in the United States. but will require up to 25% travel across the country.

Pay Range: $84,300.00 - $151,700.00 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.  Total compensation may also include additional forms of incentives.

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