Program Manager (Provider Engagement)

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: As part of our Buckeye Health Plan, a subsidiary of Centene, the Program Manager will partner with the health plan provider operations departments, sales, risk adjustment, quality and other health plan departments to enhance strategic provider relationships and develop avenues for communication that enhance member and provider engagement, claim trends and regulatory changes.

*Note - there will be travel (3-4 times per year )to the Columbus, Ohio office for in-person department meetings. Candidates residing in the Ohio area are highly preferred.

• Collaborate with various vendors and internal departments to drive key business initiatives and solutions across the enterprise to meet and exceed goals.

• Support onboarding operations for new value-based contracts.

• Work with various teams, applications, tools and platforms to evaluate provider performance metrics:  quality, cost, utilization trends.

• Assist with implementation of new applications and reporting to identify trends.

• Collaborate with provider staff to develop and implement operational and clinical process improvements to help providers achieve higher performance.

• Identify, develop, and establish key performance metrics to measure performance of providers related to their value-based contracts.

• Identify improvement opportunities based on key performance indicators and develop action plans.

• Develop and provide training and support to assist internal staff and providers in understanding performance metrics and implement operational and clinical improvements.

• Promote collaboration across provider groups to enable sharing of best practices and performance improvement opportunities.

• Resolve various system, process or resource issues to address provider feedback and concerns.

Education and Experience:

• Bachelor's degree in related field or equivalent experience.

• 5+ years of project management, provider relations, contracting, health care operations, or medical management.

• Experience in Managed Healthcare or Medicaid/Medicare industry.

• Experience with value-based contracting is highly preferred.

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