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Centene Corporation · 1 day ago

Senior Director, Value Based Performance Management

Illinois, United States

Full-time

Hybrid

Director/Executive

$148K/yr - $274K/yr

8+ years exp

Centene Corporation is transforming the health of communities across the nation, and they are seeking a Senior Director of Value Based Performance Management. This role involves creating and implementing Network Transformation initiatives, leading a team to improve provider performance, and collaborating with various departments to drive improvements in healthcare delivery.

Hospital & Health Care

Responsibilities

Leads and develops team of Provider Relations Managers and/or Network Performance advisors to meet/exceed provider performance and provider satisfaction key metrics

Conducts field rides with Provider Relations Representatives to gauge their performance and provide coaching and development in order to improve the business results

Identifies team skill set deficiencies and implements proper professional development plans

Monitors Provider Performance action plans and tracks provider performance improvement

Ensures compliance with enterprise provider performance and relationship model and team engagement of provider performance reporting

Drives improvement of provider performance by analyzing, interpreting and communicating financial, utilization and quality metrics

Establishes and leads collaborative effort with internal cross-functional market and shared services departments to support provider performance and resolve network and operational barriers/challenges

Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive improvement of quality provider performance

Responsible for understanding the differences between Risk and Value-Based contractual arrangements

Plans, prepares and executes effective group meetings/discussions with proper objectives and outcomes

Plans, conducts and directs provider contractual terms and provider account management

Assists in monitoring and developing High Performing Practices and drives Network Transformation Strategies to optimize member outcomes

Strategizes membership growth and retention for High Performing Practices, sophisticated and/or complex Provider Partnerships

Maintains compliance for State and CMS audits

Resolves high level, complex provider issues

Member of state senior leadership team

Special project as assigned or directed

Qualification

Provider Relations ManagementNetwork TransformationHEDISSTARS measuresFinancial analysisTeam leadershipCoachingDevelopmentCommunication skillsProblem-solving