Senior Director – Provider Engagement
| Company | Centene |
|---|---|
| Location | Orlando, FL, USA, Tampa, FL, USA, Miami, FL, USA, Jacksonville, FL, USA |
| Salary | $145100 – $268800 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- A Bachelor’s Degree in a related field
- 8+ years of experience in provider relations
- 5+ years of management experience
- Valid Florida driver’s license
Responsibilities
- Manages PCP and Medical Specialist providers across the state of Florida
- Drives 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
- Leads and develops team of Provider Relations Managers and/or Network Performance advisors
- Conducts field rides with Provider Relations Representatives to gauge their performance and provide coaching and development
- 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
- Responsible for understanding HEDIS and STARS measures and partners with Quality Team
- Plans, prepares and executes effective group meetings/discussions
- Plans, conducts and directs provider contractual terms and provider account management
- Assists in monitoring and developing High Performing Practices
- Strategizes membership growth and retention for High Performing Practices
- 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
Preferred Qualifications
- Managed care experience preferred