Job Description

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: Lead, negotiate, and manage multiple large hospitals and medical groups, physician, and/or ancillary contracting activities in accordance with Corporate, health plan, and state guidelines.

• Oversee all activities of the contracting department
• Develop and implement a network development plan for an assigned region and set of providers and identify and initiate contact with potential providers
• Negotiate contracts with interested providers utilizing model provider agreements, and follow up on contracts
• Lead negotiations, rate modeling, implementation and ongoing monitoring of assigned group of providers to maximize business relationships and opportunities
• Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups
• Evaluate and monitor providers’ performance standards and financial performance of contracts
• Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language
• Perform financial analyses to identify medical cost improvement opportunities and develop and execute contracting action plans to achieve results

Education/Experience: Bachelors’ degree in healthcare administration, business administration, marketing or related field or equivalent experience. 6+ years of contracting experience or provider relations in a healthcare and/or managed care environment. Knowledge of contracting language and the principles of negotiation. Familiarity with managed care, State and/or Federal health care programs.

Preferred Experience: Value Based Care contracting experience is ideal.

License/Certification: Current state driver’s license.

Candidates must be in Nevada to be considered for this position.

Pay Range: $105,600.00 - $195,400.00 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

Job Tags

Full time, Contract work, Part time, Work at office, Remote work, Flexible hours,

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