Senior Director, Physician Contracting & Network Development
Clayton, MO · Healthcare
About the Company:
A Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on underinsured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans).
The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.
Oversee the development and implementation of contracting activities in network development and enhancement.
Work with Business Development and Providers to develop a strategy for developing new networks including plans to meet network access and unit cost objectives.
Determine necessary resources to develop the network and assemble the appropriate team across all business functions. Complete development of a budget in alignment with Centene network management and financial objectives.
Support the new business launch in diverse markets while considering individual market circumstances, the provider community, budgeting constraints and available resources.
Lead the network development specialists during the implementation and development stages.
Monitor performance and develop & implement business solutions to address process and/or quality gaps. Communicate with senior management and other Centene leaders regarding network strategy and planning.
Complete negotiations with complex and major provider contracts as needed to support network objectives.
Bachelor’s degree in Healthcare Administration, Business Administration or related field.
7+ years of related contracting and/or equivalent healthcare experience.
Experience establishing new markets including the development of the strategy and oversight of the implementation.
Strong communication skills dealing with multiple levels within the organization and with the provider community.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
The company offers more than just medical insurance. They pay most of your benefits costs and in some cases – they pay 100 percent. Most of the benefits not covered by the company are paid with pre-tax payroll deductions.
Flexible spending accounts (includes health care, dependent care mass transit reimbursement)
Short- and long-term disability insurance
Basic Life insurance
Supplemental life insurance
401(k) retirement with company match
Employee stock purchase plan
Vacation, Personal and Sick time
Paid Company Holidays
Employee Assistance Program (EAP)
Training and Learning Opportunities
Tuition Reimbursement/Educational Assistance
On-site fitness center or discount at local fitness centers (most locations)
Discounts for select local and national products and services, including cell phones, computers and more
Other amenities may be available, but vary by location