Development Manager overseeing project activities for power generation projects in the West. Responsibilities include negotiations, permitting, and effective execution of projects.
About the role
- Senior Regional Provider Engagement Manager at Centene driving provider performance improvement strategies in healthcare. Engaging local markets and collaborating with leadership to enhance care outcomes.
Responsibilities
- Provide hands-on Provider Engagement Operating Model (PEOM) support and guidance focused on coaching market teams to lead effective, data-driven provider performance conversations, including in-person performance enablement sessions, new hire performance immersion, and rollout of performance-focused initiatives and reporting.
- Engage in Monthly and Quarterly PE Regional Leadership check-ins to review provider performance trends, prioritize high-impact provider groups, and align on corrective and growth strategies.
- Lead new Provider Engagement implementations within assigned regions with an emphasis on performance measurement, standardized performance templates, reporting, and accountability frameworks.
- Drive execution of key strategic initiatives that improve provider quality, cost performance, risk adjustment accuracy, pharmacy performance, and value-based outcomes across local markets.
- Support development and execution of strategic operational plans tied directly to provider performance improvement, including large-scale performance transformation initiatives.
- Collaborate with health plan leaders to support system-wide implementations that enable provider performance improvement, ensuring learnings transition from pilot to full-scale execution.
- Drive and interpret provider performance KPIs, including quality, medical expense ratio (MER/HBR), risk adjustment, pharmacy measures, and value-based performance outcomes.
- Utilize data analysis to identify provider performance gaps and develop targeted, measurable action plans to improve outcomes.
- Support local market relationships by leading structured, outcome-oriented provider performance engagement with high-impact providers rather than routine provider servicing or issue resolution.
- Partner with health plans and the enterprise Provider Experience team to monitor and improve provider performance in risk-based arrangements across multiple product lines.
- Assist in driving provider-related corporate initiatives, strategies, and goals that advance enterprise-wide provider performance and value-based care objectives.
- Analyze industry trends, provider performance models, and emerging technologies to enhance provider engagement strategies and performance outcomes.
- Analyze and interpret provider performance data using research methods to inform strategic recommendations and provider action plans.
- Prepare and deliver actionable performance insights through dashboards, presentations, and reports that directly support provider and market-level decision-making.
- Escalate systemic performance barriers and risks that impede provider outcomes to ensure timely resolution and sustained performance improvement.
- Enhance and leverage analytics, member demographics, and utilization patterns to identify provider efficiency opportunities and care delivery improvements.
- Collaborate with operational teams and vendors to address structural or process-related barriers impacting provider performance—not to manage routine claims or provider inquiries.
Requirements
- Bachelor's Degree health care administration, business, or related field or equivalent experience required
- Master's Degree health care administration, business, or related field preferred
- 6+ years In provider engagement, network management, or healthcare strategy. required
- In-depth knowledge of provider engagement, network management, and performance improvement methodologies required
- Demonstrated track record of successfully leading cross-functional provider engagement teams and driving results in a dynamic environment required
- Proven ability to influence senior leaders and manage complex initiatives.
- Strong analytical skills with proficiency in interpreting performance metrics (HEDIS, STARs, risk adjustment, cost/utilization) required
- Role requires roughly 50% local travel; mileage reimbursement will be issued.
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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