Vice President, Provider Network Strategy & Execution

$227,400 - $431,900/Yr

Centene - Austin, TX

Full-time - Executive

Austin, TX

Ambulatory Health Care Services

About the position

The Vice President of Provider Network Strategy & Execution at Centene Corporation is responsible for developing and managing the provider network strategy. This role involves overseeing various aspects of provider network strategy, including reimbursement and contracting strategies, unit cost management, claims configuration, and network operations. The position requires leadership in evaluating opportunities for network expansion and ensuring alignment with company goals.

Responsibilities

• Develop and manage the provider network strategy for Centene Corporation.
• Lead all aspects of provider network strategy including reimbursement strategy, contracting strategy, unit cost management, claims configuration, and network operations.
• Oversee network development staff and external consultants in the development of provider networks across expansion markets.
• Lead health plans in periodic analyses of their provider networks from a cost, coverage, and growth perspective.
• Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
• Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
• Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
• Lead initiatives to ensure periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
• Lead development of fee schedules and rates for new and existing markets consistent with budget and premium revenue assumptions.
• Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
• Assist health plan CEOs, network development, legal and finance teams in key provider contract negotiations and strategy.
• Work collaboratively with Business Development on new market and new product development initiatives.

Requirements

• Bachelor's degree in Business Administration, Healthcare Administration or related field.
• MBA or MHA degree preferred.
• 10+ years of experience in managed care network development.
• 3+ years of experience in government programs.
• Previous experience managing staff, including hiring, training, managing workload and performance.
• Valid driver's license.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible work schedules including remote, hybrid, field or office work options.