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Director, Contracting & Network Development - Commercial PPO, USA, California

CategoryNetwork Development & Contracting
Job typeFull Time
CountryUnited States of America
Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.

  • Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit's policies and standards, government laws and regulations
  • Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
  • Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
  • Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
  • Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
  • Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
  • Ability to travel

  • Qualifications:

    • Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience.
    • 7+ years of combined contracting, network development or provider relations experience.
    • Previous experience in Commercial Insurance contracting and negotiating hospital, large physician groups and ancillary service agreements.
    • Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff.
    License/Certification: Valid driver's license.

    Ability to travel up to 100% across the US post Covid-19 restrictions lifted
    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.
    EmployerCentene Corporation

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