Regional Vice President, Medical Management–South Region

Centene Corporation

  • Location: St. Louis, MO

Grant Cooper, a healthcare executive search firm, is seeking a Regional Vice President, Medical Management–South Region for Centene.Centene seeks a Regional Vice President, Medical Management for their south region. Centene serves more than 12 million members through programs and services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Fortune Magazine has ranked Centene Corporation No. 61 in its 2018 FORTUNE 500 list of largest corporations in the United States, ranked by revenue, up from the 66th spot in 2017.

Centene’s south region includes Florida, Texas, Louisiana, Georgia, Mississippi, South Carolina, Louisiana, Arkansas, and Arizona. This position can be domiciled within Centene’s south region.

Position Overview

Reporting to the Executive Vice President, Chief Medical Officer, the RVP of Medical Management, will plan, develop, and drive execution of medical management and quality improvement programs, processes, and initiatives to ensure improved quality outcomes, achievement of health benefit ratio targets, and reduction in administrative costs. This role will drive adoption of best practices and standardization, while developing customized approaches for unique markets and product lines. Additionally, the Regional Vice President of Medical Management will oversee corporate accreditation, quality improvement, Medical Management Operations (systems, training, auditing, reporting, centralized operations), and new business development and implementation.

Qualifications

  • RN degree, with bachelor’s or BSN required. Master’s highly preferred.
  • Ten or more years leading the medical management process, managing staff and workload performance within a managed care entity.
  • Solid understanding of appropriate metrics, measures, and outcomes, displaying a keen ability to work in a data driven environment.
  • Strong strategic and innovative approach, with depth in new processes, approaches to new technologies and programs, and performance improvement.
  • Thorough understanding of medical information systems, provider contracting approaches, and case management practices, preferably in the governmental setting.
  • Ability to implement change in a consultative approach and maneuver in a matrix reporting environment. Six Sigma experience preferred.