Head of Medicare Network Strategy

Centene is transforming the health of our communities one person at a time.  As an Executive on our team, you could be the one who changes everything for our 28 million members.
 

• Design and execute innovative value-based contracting models that align with Medicare while leveraging insights to optimize Medicaid and other product strategies.
• Foster collaborative relationships with providers to enhance quality outcomes and cost efficiency across Medicare, Medicaid, and dual-eligible populations.
• Monitor contract performance through robust data analytics, ensuring continuous improvement and alignment across products to maximize value.

Integrated Medicare Network Strategy and Development:

• Build and maintain a stable, competitive, and geographically accessible provider network across all Medicare lines of business, integrating Medicaid and other product strategies as necessary to deliver a cohesive, collaborative network framework. Lead the development of strategic partnerships and innovative contracting methodologies that address the unique needs of Medicare, Medicaid, and dual-eligible populations, creating synergies to improve care delivery and reduce costs across the organization.
   
• Ensure networks remain adaptable and are a competitive advantage in an evolving healthcare landscape.

Quality and Affordability Initiatives:

• Identify and drive initiatives to reduce medical cost trends while maintaining or improving care quality and access for Medicare and other covered populations. Develop and implement data-driven processes to identify and address variations in care delivery and provider performance across all product lines. Collaborate with key stakeholders to establish cost containment strategies that enhance member satisfaction and align with financial objectives.

Provider Experience and Accountability:

• Strengthen provider relationships by fostering trust, transparency, and collaboration in support of shared enterprise goals. Oversee the implementation of value-based care initiatives, driving measurable improvements in provider quality and cost performance.

Regulatory Compliance and Operational Excellence:

• Ensure all network strategies and initiatives comply with federal, state, and local regulations governing Medicare, Medicaid, and other product lines. Drive operational efficiency by integrating best practices and innovative technologies across network management functions, in support of consistency and scalability across product portfolios.
   
• Drives business results through inspirational leadership, empowering people to act with speed, agility, and accountability aligned with Centene culture.
   
• Performs other duties as assigned.
   
• Complies with all policies and standards.

Education/Experience: Bachelor’s degree required in Business Administration, Healthcare Administration or related field. Master’s degree in related field preferred. 12+ years of network development, network operations or provider relations in a managed care organization.

Pay Range: $250,000.00 - $625,000.00 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