Centene Corporation
Regional Provider Engagement Manager
Centene Corporation, Chicago, Illinois, United States, 60290
Position Purpose
As the Regional Provider Engagement Manager, you will support provider performance and engagement efforts within a specific region that includes multiple local markets. This role will drive strategies and initiatives that support improvements in provider quality, cost‑effectiveness, and clinical efficiency.
Qualifications
Must reside in Chicago, IL or surrounding areas. The role requires both in‑office presence and regional travel.
Bachelor's Degree in health care administration, business, or a related field (equivalent experience acceptable). Master’s Degree preferred.
5+ years of experience in provider management or healthcare strategy.
In-depth knowledge of provider engagement, network management, and performance‑improvement methodologies.
Demonstrated track record of leading cross‑functional provider engagement teams and driving results in a dynamic environment.
Key Responsibilities
Provide hands‑on PEOM support and guidance, including in‑person training, new‑hire onboarding, process reinforcement, and rollout of new reports or initiatives for assigned markets.
Engage in monthly/quarterly PE regional leadership check‑ins.
Lead new PE implementations within assigned regions (templates, reporting, etc.).
Drive the execution of key strategic initiatives to support local markets and recommend opportunities for increasing business value.
Support the development of strategic operational plans and monitor implementation, including large‑scale transformation projects.
Collaborate with health‑plan leaders to facilitate system‑wide implementations and ensure continuous improvement from pilot to full‑scale deployment.
Drive key performance indicators (KPIs) and interpret data to improve provider performance.
Utilize data analysis to identify service‑level improvement opportunities and develop specific actions based on findings.
Maintain high‑touch, responsive service for critical providers through shared‑service resources.
Partner with health plans and the enterprise Provider Experience team to monitor provider performance of risk arrangements for multiple product lines.
Assist in developing provider‑related corporate initiatives, business plans, strategies, and goals.
Analyze industry trends and emerging technologies to maintain cutting‑edge services and capitalize on opportunities.
Apply research methods and techniques to analyze facts/results.
Prepare actionable reports and communicate status via project plans, dashboards, presentations, or other tools.
Escalate issues as appropriate to ensure timely resolution and on‑time project delivery.
Leverage analytics, member demographics, and healthcare facility usage patterns to identify efficiency opportunities.
Collaborate with operational areas and vendors on initiatives supporting provider performance and financial efficiencies.
Perform special projects as assigned or directed.
Perform any other duties as assigned.
Ensure compliance with all policies and standards.
Train market associates on provider performance to improve Medical Expense Ratio, Risk Adjustment accuracy, and overall financial outcomes.
Teach teams how to plan, execute, and leverage Joint Operations Committee meetings to align providers and internal teams on performance goals.
Train associates to interpret and act on financial and quality metrics (e.g., HEDIS, STARs) to drive targeted improvement strategies.
Educate market teams on building strong provider relationships, optimizing incentive programs, and implementing value‑based care models.
Compensation & Benefits Pay Range: $86,000 per year – $154,700 per year.
Centene offers a comprehensive benefits package with competitive pay, health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off and holidays, and flexible work arrangements (remote, hybrid, field or office).
Equal Opportunity Employer Centene is an equal opportunity employer committed to diversity and values our differences. 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 any other characteristic protected by law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
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Qualifications
Must reside in Chicago, IL or surrounding areas. The role requires both in‑office presence and regional travel.
Bachelor's Degree in health care administration, business, or a related field (equivalent experience acceptable). Master’s Degree preferred.
5+ years of experience in provider management or healthcare strategy.
In-depth knowledge of provider engagement, network management, and performance‑improvement methodologies.
Demonstrated track record of leading cross‑functional provider engagement teams and driving results in a dynamic environment.
Key Responsibilities
Provide hands‑on PEOM support and guidance, including in‑person training, new‑hire onboarding, process reinforcement, and rollout of new reports or initiatives for assigned markets.
Engage in monthly/quarterly PE regional leadership check‑ins.
Lead new PE implementations within assigned regions (templates, reporting, etc.).
Drive the execution of key strategic initiatives to support local markets and recommend opportunities for increasing business value.
Support the development of strategic operational plans and monitor implementation, including large‑scale transformation projects.
Collaborate with health‑plan leaders to facilitate system‑wide implementations and ensure continuous improvement from pilot to full‑scale deployment.
Drive key performance indicators (KPIs) and interpret data to improve provider performance.
Utilize data analysis to identify service‑level improvement opportunities and develop specific actions based on findings.
Maintain high‑touch, responsive service for critical providers through shared‑service resources.
Partner with health plans and the enterprise Provider Experience team to monitor provider performance of risk arrangements for multiple product lines.
Assist in developing provider‑related corporate initiatives, business plans, strategies, and goals.
Analyze industry trends and emerging technologies to maintain cutting‑edge services and capitalize on opportunities.
Apply research methods and techniques to analyze facts/results.
Prepare actionable reports and communicate status via project plans, dashboards, presentations, or other tools.
Escalate issues as appropriate to ensure timely resolution and on‑time project delivery.
Leverage analytics, member demographics, and healthcare facility usage patterns to identify efficiency opportunities.
Collaborate with operational areas and vendors on initiatives supporting provider performance and financial efficiencies.
Perform special projects as assigned or directed.
Perform any other duties as assigned.
Ensure compliance with all policies and standards.
Train market associates on provider performance to improve Medical Expense Ratio, Risk Adjustment accuracy, and overall financial outcomes.
Teach teams how to plan, execute, and leverage Joint Operations Committee meetings to align providers and internal teams on performance goals.
Train associates to interpret and act on financial and quality metrics (e.g., HEDIS, STARs) to drive targeted improvement strategies.
Educate market teams on building strong provider relationships, optimizing incentive programs, and implementing value‑based care models.
Compensation & Benefits Pay Range: $86,000 per year – $154,700 per year.
Centene offers a comprehensive benefits package with competitive pay, health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off and holidays, and flexible work arrangements (remote, hybrid, field or office).
Equal Opportunity Employer Centene is an equal opportunity employer committed to diversity and values our differences. 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 any other characteristic protected by law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
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