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.
 

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

Position Purpose: Manage all aspects of vendor activity, including but not limited to vendor compliance, engagement, oversight, and performance.

• Ensure operation integrity, including compliance with all policies and procedures for the Health Plan including adherence to state contract and guidelines.
• Develop correction action and quality improvement plans for standards that are not met by vendors.
• Provide guidance on researching and resolving claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution.
• Conduct monthly meetings document, discuss, and resolve issues as well as monitor completion of action items.
• Direct negotiations and draft vendor RFI’s, RFP’s, SOW, and contracts.
• Assist with the onboarding and transition of new vendors.
• Monitor compliance with all contractual requirements, vendor performance and reporting.
• Managing relationships with vendor partners to promote and maintain a high engagement.
• Manage staff of vendor analyst and oversee their growth and development and assimilation into the vendor management department and the organization.

Education/Experience:

• Bachelor’s degree in business administration, public administration or related field or equivalent experience.
• 5+ years of healthcare management experience, preferably in vendor managed care or the health insurance field.
• Experience with reporting and analyzing data.
• Strong Excel skills and working with a variety of software data programs preferred.
• Project management experience preferred.

Licenses/Certifications:

• Certified Third Party Risk Professional (CTPRP) Preferred.

Pay Range: $103,500.00 - $191,600.00 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