Vice President, Network Strategy – Management, Value-Based Contracting

This is a fully remote position, open to applicants in Missouri, +1 more state.

📋 Description

• Accountable for the development and management of the provider network strategy for Centene Corporation.

• Oversee all elements of provider network strategy, which encompasses reimbursement strategies, contracting strategies, unit cost management, claims configuration, and network operations.

• Supervise network development personnel and external consultants in the establishment of provider networks within expansion markets.

• Lead health plans in conducting periodic evaluations of their provider networks from perspectives of cost, coverage, and growth.

• Provide leadership in assessing opportunities to expand or modify the network to align with company objectives.

• Manage budgeting and forecasting efforts related to product lines, network expenses, and provider contracts.

• Direct the analysis of claim trend data and/or market intelligence to derive insights that support contract negotiations.

• Spearhead initiatives to guarantee regular reviews of provider contracting rates, ensuring alignment with the overall company strategy.

• Guide the development of fee schedules and rates for both new and existing markets, consistent with budget and premium revenue forecasts.

• Support market expansion and M&A initiatives by leading provider contract analysis during due diligence processes.

• Assist health plan CEOs, network development teams, legal, and finance departments in critical provider contract negotiations and strategies.

• Collaborate effectively with Business Development on new market and product development initiatives.

• Willingness to travel.

⛳️ Requirements

• Bachelor’s degree in business administration, healthcare administration, or a related field is required.

• An MBA or MHA degree is preferred.

• Over 10 years of experience in managed care network development.

• At least 3 years of experience in government programs.

• Proven track record in leading large-scale, multi-market VBC programs across Medicaid, Medicare (including MA/D-SNP), and/or commercial markets is preferred.

• Prior experience in managing staff, including hiring, training, workload management, and performance evaluation.

• A valid driver's license is required.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K and stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements with options for remote, hybrid, field, or office schedules.