Senior Manager, Provider Relations

Centene
Delaware, Maryland, New Jersey, Pennsylvania
Workplace: RemoteFull timeUSD 87,700 - 157,800 annuallyFunction: Solutions Engineering & Sales EngineeringExperience: 6+ yearsEducation: bachelorsSkills: ["Leadership","Coaching","Mentoring","Compliance","Strategic planning"]

Lead a Provider Relations team to manage a regional/market territory and drive network performance improvement. You’ll develop Provider Relations staff, coach reps through field ride-alongs and feedback, and monitor provider performance action plans. Partner with Quality to improve HEDIS and STARS outcomes, ensure compliance with contractual and regulatory requirements, and advance provider satisfaction and experience through network transformation strategies.

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FursaFursa
Centene
Centene
1 day ago

Senior Manager, Provider Relations

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Last checked: 5 hours agoStatus: Live

Job Summary

Lead a Provider Relations team to manage a regional/market territory and drive network performance improvement. You’ll develop Provider Relations staff, coach reps through field ride-alongs and feedback, and monitor provider performance action plans. Partner with Quality to improve HEDIS and STARS outcomes, ensure compliance with contractual and regulatory requirements, and advance provider satisfaction and experience through network transformation strategies.
Location: Delaware, Maryland, New Jersey, Pennsylvania
Workplace: Remote
Employment Type: Full time
Job Function: Solutions Engineering & Sales Engineering
Seniority: Manager level

Key Responsibilities

  • •Lead and develop Provider Relations Representatives, Provider Relations Supervisors, and/or Network Performance Advisors.
  • •Conduct ride-alongs and provide timely field trip reports and formative feedback to improve team performance.
  • •Monitor provider performance action plans and track provider performance improvement.
  • •Ensure compliance with enterprise provider performance and the provider performance and relationship model, including contractual and regulatory requirements.
  • •Partner with Quality to drive improvement in HEDIS and STARS measures and lead network transformation strategies to improve member outcomes.

Pay and Benefits

Salary: USD 87,700 - 157,800 annually
Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

  • •Bachelor’s degree in a related field.
  • •6+ years of experience in provider relations or a similar background.
  • •3+ years of management experience.
  • •Knowledge of risk and value-based contractual arrangements.
  • •Working knowledge of HEDIS and STARS measures to drive quality provider performance.
Experience:6+ yearsHealthcareProvider relationsValue-based care
Education:Bachelor's
Skills:LeadershipCoachingMentoringComplianceStrategic planning

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn