Hybrid Senior Regional Provider Engagement Manager

at Centene Corporation

• Job title: Senior Regional Provider Engagement Manager
• Job type: Full Time
• Experience level: Senior
• Salary: $87,700 - $157,800 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Chicago, United States

About the role

• Senior Regional Provider Engagement Manager at Centene driving provider performance and engagement efforts across a specific region. Focusing on performance improvement strategies while engaging with market leadership.

Responsibilities

• Train on Provider Performance: Equip market associates with the knowledge and tools to improve Medical Expense Ratio, Risk Adjustment accuracy, and overall financial outcomes.
• Guide Effective JOCs: Teach teams how to plan, execute, and leverage Joint Operations Committee meetings to align providers and internal teams on performance goals.
• Develop Data Proficiency: Train associates to interpret and act on financial and quality metrics (e.g., HEDIS, STARs) to drive targeted improvement strategies.
• Coach on Engagement Strategies: Educate market teams on building strong provider relationships, optimizing incentive programs, and implementing value-based care models.
• 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.
• Perform special projects as assigned or directed.
• Complies with all policies and standards.

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 required
• Strong analytical skills with proficiency in interpreting performance metrics (HEDIS, STARs, risk adjustment, cost/utilization) required

Benefits

• 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