You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Oversees Product Operations for a line of business, including potentially serving as the official Contract Manager. Serves as the primary day-to-day liaison for the Agency or Vendor, including interpretation and dissemination of agency/vendor guidance, immediate resolution of escalated issues, and proposals from the health plan to agency/vendor.
- Develops strategies to meet or exceed compliant operations and expansion of products and services within the State.
- Identifies implementation and operational gaps and leads teams to implement new processes and oversees results.
- Ensures all operations are in compliance with contractual requirements.
- Produces operational reporting for executive management.
- Facilitates problem identification, solution development, and initiative implementation to continuously improve processes to enhance member and provider experience, while driving financial performance of the program.
- Oversees the day-to-day relationship with the Agency for Healthcare Administration.
- Oversees the operational aspects of the product/service.
- Assesses market dynamics, competitive position and operational performance, and performs strategic planning and annual forecasting activities for product/service.
- Oversees implementation of initiatives associated with contractual compliance and product improvement and drives to completion.
- Builds and enhances relationships with corporate, providers, members, and external partners in the community to support plan and company mission and create compliant opportunities for growth within the state.
- Serves as subject matter expert on relevant contract(s), proposal(s), and agency/vendor guidance.
- Works closely with the Senior Director, Regulatory Affairs and Compliance Liaison to ensure compliance within all areas of the product/service.
- Evaluates sales, contracting, and operational processes for "best practice" development in all areas of the business.
- Partners with all departments in the organizations, which include, but are not limited to: finance, provider relations, customer service, health services, utilization management, Medicare sales, and community relations.
- Performs other duties as assigned.
- Serve as the subject matter expert on ACHA contract(s), proposal(s) and ACHA guidance.
- Ensures all operations are in compliance with state and federal regulatory requirements and Centene and Health Plan procedures and policies.
Candidate Education: A Bachelor's Degree in business administration / related field or equivalent work experience required. Master’s degree preferred. 6+ years of experience in project management, strategic planning and development, product management, and financial management, including 4+ years of experience in health care or managed care environment and 2+ years experience leading/supervising others required. 2+ years of experience working with state reporting and regulatory/government affairs preferred.
Pay Range: $105,600.00 - $195,400.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. 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 other characteristic protected by applicable 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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