Senior Director, Provider Engagement Position Available In Hillsborough, Florida
Tallo's Job Summary: The Senior Director, Provider Engagement position at Centene manages PCP and Medical Specialist providers in Florida. Responsibilities include improving network quality, implementing initiatives, developing provider relations team, and driving provider performance. This role requires a Bachelor's Degree, 8+ years of provider relations experience, and 5+ years of management experience. The pay range is $145,100.00 - $268,800.00 per year with competitive benefits.
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. •
Position Purpose:
•This role specifically manages PCP and Medical Specialist providers across the state of Florida. Key responsibilities include driving the health plan’s quality performance to maintain a high quality network. Creates and implements Network Transformation initiatives across a market. Develops Provider Relations Management team to effectively achieve market targets while collaborating with internal departments to drive improvement of provider performance. + Leads and develops team of Provider Relations Managers and/or Network Performance advisors to meet/exceed provider performance and provider satisfaction key metrics. + Conducts field rides with Provider Relations Representatives to gauge their performance and provide coaching and development in order to improve the business results. + Identifies team skill set deficiencies and implements proper professional development plans. + Monitors Provider Performance action plans and tracks provider performance improvement. + Implements strategy to provide a positive impact on the provider experience + Ensures compliance with enterprise provider performance and relationship model and team engagement of provider performance reporting. + Drives improvement of provider performance by analyzing, interpreting and communicating financial, utilization and quality metrics. + Establishes and leads collaborative effort with internal cross-functional market and shared services departments to support provider performance and resolve network and operational barriers/challenges. + Responsible for understanding HEDIS and STARS measures and partners with Quality Team to drive improvement of quality provider performance. + Responsible for understanding the differences between Risk and Value-Based contractual arrangements. + Plans, prepares and executes effective group meetings/discussions with proper objectives and outcomes. + Plans, conducts and directs provider contractual terms and provider account management. + Assists in monitoring and developing High Performing Practices and drives Network Transformation Strategies to optimize member outcomes. + Strategizes membership growth and retention for High Performing Practices, sophisticated and/or complex Provider Partnerships. + Maintains compliance for State and CMS audits. + Resolves high level, complex provider issues. + Member of state senior leadership team. + Special projects as assigned or directed. + 30% instate Florida travel required.
Candidate Education:
Required A Bachelor’s Degree in a related field.
Candidate Experience:
Required 8+ years of experience in provider relations experience. Required 5+ years of management experience. Managed care experience preferred. This position is remote within the state of Florida. Candidates must reside in Florida in order to be considered. 30% in state travel required. Valid Florida driver’s license required.
Pay Range:
$145,100.00 – $268,800.00 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. Total compensation may also include additional forms of incentives. 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