Senior Manager, Provider Relations
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Job Description
Senior Manager leading provider relations and network performance for Centene, a national healthcare organization serving 28 million members. Driving provider quality, partnerships, and network transformation across four U.S. states.
Responsibilities:
- Lead a team of Provider Relations Representatives, Network Performance Advisors and/or Provider Relations Supervisors
- Manage assigned region and/or market territory
- Develop the Provider Relations Team to achieve market performance targets
- Implement and execute network transformation strategies to improve overall network performance
- Conduct field ride-alongs and provide timely formative feedback through Field Trip Reports
- Monitor provider performance action plans and track improvement
- Ensure compliance with provider performance and relationship models and provider performance reporting
- Partner with the Quality Team to improve provider performance related to HEDIS and STARS measures
- Plan and execute effective group meetings and discussions
- Ensure adherence to contractual obligations and regulatory requirements
- Improve Provider Satisfaction and Provider Experience
- Monitor and develop High Performing Practices and drive Network Transformation Strategies to optimize member outcomes
- Educate and enhance provider partnerships and implement market and enterprise initiatives
- Strategize membership growth for High Performing Practices and complex provider relationships
- Train, mentor and guide new managers
- Lead and develop Provider Operations staff
- Complete special projects as assigned or directed
Requirements:
- Bachelor's Degree in a related field
- 6+ years of experience in provider relations or similar background
- 3+ years of management experience
- Equivalent work experience accepted as an alternative to the required bachelor's degree
- Understanding of Risk and Value-Based contractual arrangements
- Understanding of HEDIS and STARS measures
- Ability to ensure adherence to contractual obligations and regulatory requirements
Benefits:
- Competitive pay
- Health insurance
- 401K plans
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity
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