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Vice President, Network Strategy – Management Value-Based Contracting

Job Description:

Responsible for developing and managing the provider network strategy for Centene Corporation
Lead all aspects of provider network strategy including reimbursement strategy, contracting strategy, unit cost management, claims configuration and network operations
Oversee network development staff and external consultants in the development of provider networks across expansion markets
Lead health plans in periodic analyses of their provider networks from a cost, coverage, and growth perspective
Provide leadership in evaluating opportunities to expand or change the network to meet Company goals
Manage budgeting and forecasting initiatives for product lines to network costs and provider contracts
Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations
Lead initiatives to ensure periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy
Lead development of fee schedules and rates for new and existing markets consistent with budget and premium revenue assumptions
Support market expansion and M&A activities by leading provider contract analysis related to due diligence
Assist health plan CEOs, network development, legal and finance teams in key provider contract negotiations and strategy
Work collaboratively with Business Development on new markets and new product development initiatives
Ability to travel
Performs other duties as assigned

Requirements:

Bachelor’s degree in business administration, healthcare administration or related field required
MBA or MHA degree preferred
10+ years of experience in managed care network development
3+ years of experience in government programs
Demonstrated success leading large‑scale, multi‑market VBC programs across Medicaid, Medicare (including MA/D‑SNP), and/or commercial markets preferred
Previous experience managing staff, including hiring, training, managing workload and performance
Valid driver's license

Benefits: