Senior National VBC Performance Manager

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.
 

Field based position – travel within NYC required

Bilingual English/Mandarin OR English/Spanish highly preferred

Position Purpose: Manages the most complex national Advanced Practice Partnerships (APP), supporting enterprise KPIs, goals and growth. Responsible for assisting in developing, executing, and maintaining APP strategy. Continuously evaluates APP relationships to ensure quality and cost performance meets or exceeds expectation, ensuring optimal functionality and efficiency. Facilitates problem identification, solution development, and initiative implementation to continually improve processes to enhance member and provider experience, while driving financial performance of the program. Works with Market and Shared Services stakeholders to achieve Market and enterprise goals.

• Manages and develops APP relationships, providing high-touch and responsive servicing of APPs.
• Manages the holistic relationship with APP with performance management oversight including but not limited to membership growth, quality, operational excellence and financial performance.
• Manages the enterprise’s most complex contractual-model relationships including Value-Based Contracting (VBC), Service Fund, and Capitation (Percent of Premium) including regular interfacing with CEOs and CFOs of both publically traded and private-equity held companies with market capitalization(s) in excess of $1 billion, respectively.
• Executively manages APP with more than 165,000 Medicare members and annualized revenue totaling $2.2+ billion, representing 15%+ of the enterprise’s national Medicare portfolio.
• Builds highly intricate and complex multi-year business-development plans with existing and potential APP(s) for multi-service area, multi-million dollar expansion(s).
• Performs contractual performance analysis and makes contractual recommendations for such matters including but not limited to new Agreements, Renewals, Amendments and Settlements.
• Assists in managing complex APP inputs into annual product bid-design including but not limited to existing products, tiered products, and provider-specific plans (PSP).

Education/Experience: Bachelor’s degree in Business or related field or equivalent work experience. Minimum of seven year’s experience in healthcare sector, preferably within a HMO or PPO environment with a minimum of six years in HMO provider relations, contracting and network development or large physician/provider organizations.

Pay Range: $86,000.00 - $154,700.00 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 …