Job Description

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.

Job Description

***Candidate must reside in either Atlanta, GA, Austin TX, Chicago IL or surrounding areas. Role will require both in office presence as well as travel throughout the region. Highly preferred that candidate possess experience in the following areas:

• Train on Provider Performance: Equip market associates with the knowledge and tools to improve Medical Expense Ratio, Risk Adjustment accuracy, and overall financial outcomes.

• Guide Effective JOCs: Teach teams how to plan, execute, and leverage Joint Operations Committee meetings to align providers and internal teams on performance goals.

• Develop Data Proficiency: Train associates to interpret and act on financial and quality metrics (e.g., HEDIS, STARs) to drive targeted improvement strategies.

• Coach on Engagement Strategies: Educate market teams on building strong provider relationships, optimizing incentive programs, and implementing value-based care models. ***

Position Purpose:
The Regional Provider Engagement Manager will support provider performance and engagement efforts within a specific region that includes multiple local markets. This role will drive strategies and initiatives that support improvements in provider quality, cost-effectiveness, and clinical efficiency.

• Provide hands-on PEOM support and guidance to include in person training, new hire following, process re-enforcement, new reports/initiatives roll out for assigned markets (All Levels)
• Engage in Monthly/Quarterly PE Regional Leadership Check-ins
• Lead new PE implementations within assigned regions (Templates, reporting, etc.)
• Drive the execution of key strategic initiatives to support local markets, recommending opportunities for increasing business value.
• Support the development of strategic operational plans and monitor implementation, including large-scale transformation projects.
• Collaborate with health plan leaders to assist in facilitating system-wide implementations and ensure continuous improvement from pilot to full-scale implementation.
• Drive key performance indicators (KPIs) and interpret data to improve provider performance.
• Utilize data analysis to identify areas for service level improvements and develop specific actions based on findings.
• Support local market relationships, providing high-touch and responsive servicing of critical providers through shared service resources.
• Partner with health plans and enterprise Provider Experience team to monitor provider performance of risk arrangements for multiple product lines.
• Assist in driving development of provider-related corporate initiatives, business plans, strategies, and goals.
• Analyze industry trends and new technologies to maintain cutting-edge services and capitalize on emerging opportunities.
• Analyze and interpret facts/results using research methods and techniques.
• Prepare meaningful, actionable reports and provide routine communication of status via project plans, dashboards, presentations, or other tools as appropriate.
• Escalate issues, as appropriate, to ensure timely resolution and on-time project delivery.
• Enhance and leverage analytics, member demographics, and healthcare facility usage patterns to identify efficiency opportunities.
• Collaborate with operational areas and appropriate vendors on initiatives supporting provider performance and financial efficiencies.
• Perform special projects as assigned or directed.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Bachelor's Degree health care administration, business, or related field or equivalent experience required

Master's Degree preferred
5+ years within provider management or healthcare strategy required

In-depth knowledge of provider engagement, network management, and performance improvement methodologies required.

Demonstrated track record of successfully leading cross-functional provider engagement teams and driving results in a dynamic environment required.

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 adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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

Job Tags

Full time, Part time, Work at office, Local area, Remote work, Flexible hours,

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