What are the responsibilities and job description for the VP, Network Development position at Superior HealthPlan?
Transforming the Health of Our Communities
About This Opportunity
As an Executive on our team, you will play a pivotal role in shaping the future of healthcare for our 28 million members.
Position Overview
This leadership position involves directing the provider network and contracting activities. You will lead all aspects of provider network strategy, including access analysis, network operations, and supporting decision-makers with analysis related to reimbursement and unit cost management.
Main Responsibilities:
- Establish strategic vision, objectives, and policies for the department.
- Develop, implement, and maintain production and quality standards for the Contracting department.
- Oversee network development staff and external consultants in developing provider networks across expansion markets.
- Perform periodic analyses of the provider network 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 for contract negotiations.
- Conduct periodic reviews of provider contracting rates to ensure alignment with overall company strategy.
- Support market expansion and M&A activities by leading provider contract analysis for due diligence.
- Assist health plan CEO and/or COO vendors in key provider relations and strategy.
Requirements
Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration, or a related field is required. An MBA or MHA degree is preferred. A minimum of 10 years of experience in managed care network development and provider relations/contracting management in a healthcare and/or managed care environment is necessary. Previous management experience, including responsibilities for hiring, training, assigning work, and managing performance of staff, is also required.
Preferred Experience
Contracting experience for Medicaid, Medicare, Marketplace, VBC, and Risk Agreements in Medicare is highly desirable.
About Us
Centene is a committed equal opportunity employer that values diversity. We offer a comprehensive benefits package, including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements. Actual pay will be adjusted based on individual skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional incentives.
Contact Information
Please note that we do not provide contact information for applicants. 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.
