Vice President, Prospective Programs (Remote)

Centene
Missouri
Workplace: RemoteFull timeUSD 188,900 - 359,800 annuallyFunction: Executive & General ManagementExperience: 10+ yearsEducation: bachelorsSkills: ["Executive leadership","Communication","Stakeholder management"]

Lead Centene’s enterprise prospective risk adjustment programs across Medicare, Marketplace, and Medicaid, setting strategy, governance, and operational performance. Oversee IHA and IOA vendor programs and own the CoC+ program, driving provider engagement, clinical documentation improvement, and accurate risk adjustment outcomes. Establish performance measures and accountability frameworks, and partner across clinical, quality, provider engagement, finance, compliance, claims, network, procurement, and technology leaders to improve documentation accuracy and business results.

Loading

Loading job details...

Preparing the role view and application actions.

FursaFursa
Centene
Centene
2 days ago

Vice President, Prospective Programs (Remote)

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 2 hours agoStatus: Live

Job Summary

Lead Centene’s enterprise prospective risk adjustment programs across Medicare, Marketplace, and Medicaid, setting strategy, governance, and operational performance. Oversee IHA and IOA vendor programs and own the CoC+ program, driving provider engagement, clinical documentation improvement, and accurate risk adjustment outcomes. Establish performance measures and accountability frameworks, and partner across clinical, quality, provider engagement, finance, compliance, claims, network, procurement, and technology leaders to improve documentation accuracy and business results.
Location: Missouri
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Sr. Director level

Key Responsibilities

  • •Lead enterprise prospective risk adjustment strategy, operations, and governance across all lines of business.
  • •Oversee IHA vendor strategy and performance, including contracting, capacity planning, outreach effectiveness, visit completion, claims submission, invoice accuracy, service levels, and issue resolution.
  • •Lead IOA vendor oversight and program strategy aligned to business priorities, provider workflows, risk adjustment goals, compliance expectations, and market needs.
  • •Own CoC+ program strategy and execution, including program design, provider enablement, appointment agenda adoption, performance monitoring, and cross-functional coordination.
  • •Establish performance measures and governance processes, partner with key leaders across the organization to improve outcomes, and serve as a strategic advisor to executive leadership.

Pay and Benefits

Salary: USD 188,900 - 359,800 annually
Equity and Bonus:Equity
Perks:Health Insurance401kEquityPaid Leave

Key Requirements

  • •Bachelor’s degree in healthcare administration, business, clinical discipline, health information management, finance, analytics, or related field.
  • •Master’s degree in a related field is preferred.
  • •10+ years of progressive healthcare leadership experience, including risk adjustment, provider engagement, clinical documentation improvement, quality, or related healthcare operations.
  • •Experience leading enterprise programs across multiple markets and lines of business (Medicare, Marketplace, Medicaid).
  • •Experience leading strategic initiatives, provider-facing programs, vendor partnerships, and cross-functional teams; plus vendor strategy and performance including contract compliance and corrective actions.
Experience:10+ yearsHealthcareMedicareMedicaidRisk adjustment
Education:Bachelor's
Skills:Executive leadershipCommunicationStakeholder management

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