Submission for the position: Manager, Contracting & Network Development - (Job Number: 1210471)
https://centene.taleo.net/careersection/jobdetail.ftl?job=1210471&lang=en
Manager, Contracting & Network Development
Position Purpose:
Provide support for the management of physician, hospital and ancillary provider recruitment in accordance with corporate, health plan and state guidelines for assigned regions.
• Implement development activities for the recruitment and contracting of providers in provider networks in new and prospective markets
• Promote, maintain and manage team goals and objectives through effective hiring, performance management, coaching and career development
• Collaborate interdepartmentally for new and existing market expansions to ensure network operations deliverables are identified and completed as defined by the state Request for Proposals (RFPs) and/or state contract
• Manage and conduct effective contract negotiations and develop strategies, tactics and methods for specific network development initiative
• Manage provider data management functions through a new RFP and/or state contract implementation with strategies that promote provider network
• Monitor operational and financial performance of contracts to guide future recruitment activities and future contract negotiations
• Develop a comprehensive provider network to meet or exceed contractual requirements
• Contribute to the development and use of provider marketing and training materials assuring compliance with all state, federal, and product guidelines in new and existing markets
• Contribute to the development of contract reimbursement methodologies, reimbursement allotment, and covered benefit grid to ensure contracts and fee schedules are performing optimally
• Ability to travel
Education/Experience:
Bachelor’s degree in Health Administration, Business Administration, related field, or equivalent experience. 4 years of provider recruitment, contracting, contract analysis, or provider relations experience. Must be knowledgeable of network development processes, contract language, principles of negotiation, credentialing and call center operations.
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.
Network Development & Contracting
USA-Florida-Tampa
Sunshine State Health Plan
Schedule: Full-time Location(s): USA-Florida-Tampa