Director, Contracting & Network Development
Posted on: 27 Nov 2021
Tampa, FL
Job Description
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
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
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
Education/Experience:
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 Medicaid/Medicare 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.
WellCare
Tampa, FL
WellCare Health Plans, Inc. provides government-sponsored managed care services. The company operates in three segments: Medicaid Health Plans, Medicare Health Plans, and Medicare Prescription Drug Plans (PDPs). The Medicaid Health Plans segment offers plans for beneficiaries of temporary assistance for needy families, supplemental security income, and aged blind and disabled residents; and other state-based programs, such as children's health insurance programs and long-term services and supports programs for qualifying families who are not eligible for Medicaid.
The Medicare Health Plans segment provides Medicare, a federal program that provides eligible persons aged 65 and over, as well as some disabled persons with a range of hospital, medical, and prescription drug benefits; Medicare Advantage, a Medicare’s managed care alternative to the original Medicare program, which offers individuals standard Medicare benefits directly through Centers for Medicare & Medicaid Services; and coordinated care plans that are administered through health maintenance organizations and require members to seek health care services and select a primary care physician from a network of health care providers.
The Medicare PDPs segment provides Medicare part D PDP plans to Medicare-eligible beneficiaries. Its PDP plans offer national in-network prescription drug coverage, including a preferred pharmacy network. As of December 31, 2018, the company served approximately 5.5 million members in the United States. WellCare Health Plans, Inc. was founded in 1985 and is headquartered in Tampa, Florida.
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IndustryHealthcare
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No. of Employees12, 000
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Website
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Jobs Posted917
