Director of Network Contracting and Management

1 week ago


Pittsburgh, Pennsylvania, United States Centene Corporation Full time
We're seeking a Senior Leader in Managed Care Network Development to join our team at Centene Corporation. As an Executive Network Director, you'll be responsible for directing all aspects of provider network strategy, including access analysis, network operations, and decision-making support for reimbursement and unit cost management.
This role involves overseeing the coordination and negotiation for the contracting department and ensuring that our provider networks are aligned with company goals. You'll also evaluate opportunities to expand or change the network to meet company goals and manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
Key Responsibilities:
  • Direct the provider network and contracting activities.
  • Lead all aspects of provider network strategy, including access analysis, network operations, and decision-making support for reimbursement and unit cost management.
  • Oversee the coordination and negotiation for the contracting department.
  • Evaluate opportunities to expand or change the network to meet company goals.
  • Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
  • Support market expansion and M&A activities by leading provider contract analysis related to due diligence.

Requirements:
  • Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration, or a related field.
  • MBA or MHA degree preferred.
  • 10+ years of experience in managed care network development and provider relations/contracting management in a healthcare and/or managed care environment.
  • Previous management experience including responsibilities for hiring, training, assigning work, and managing performance of staff.
  • Valid driver's license.


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