Vice President of Medical Management | MHS Health

Centene Corporation

  • Location: Milwaukee, WI

Grant Cooper, a healthcare executive search firm, is seeking a Vice President of Medical Management for MHS Health, a Centene subsidiary.MHS Health is a managed care company that employs more than 150 people in its Milwaukee office. MHS Health is a wholly owned subsidiary of Centene Corporation, a leading multi-line healthcare enterprise offering both core Medicaid and specialty services. MHS Health has a commitment to improving the health of the community one individual at time through affordable and reliable healthcare plans. Founded as a single health plan in 1984, Centene Corporation (Centene) has established itself as a national leader in the healthcare services field. Today, through a comprehensive portfolio of innovative solutions, it remains deeply committed to delivering results for its stakeholders: state governments, members, providers, uninsured individuals and families, and other healthcare and commercial organizations. Fortune Magazine has ranked Centene Corporation No. 66 in its annual FORTUNE 500 list of largest corporations in the United States, ranked by revenue, up from 124th spot last year. Centene has risen 420 spots since first entering the list in 2010.

Position Overview

Centene seeks a Vice President of Medical Management for their health plan in Wisconsin.  MHS Health Wisconsin covers a large population of members in Medicaid, Medicare Advantage, and other governmental programs. MHS Health Wisconsin is a 3.5 STAR rated health plan by CMS and poised for market growth. Reporting to the CEO and Plan President, the Vice President of Medical Management will lead the development and implementation of short term, long term, and cost saving initiatives of MHS Health Wisconsin’s plans and products. This role will oversee all aspects of disease and care management processes, and play a key role in the strategic development of the health plan, interacting with key stakeholders, provider leaders, and regulatory authorities.

Qualifications

  • RN degree, with Bachelor’s or BSN required. Master’s preferred.
  • Prior experience leading the care management process in a health plan or health system with a risk-based arrangement (ACO or value-based reimbursement).
  • Thorough understanding of medical information systems, medical claims payment process, coding, and case management practices, preferably in the governmental setting.
  • Proven background leading a large staff of case managers, including responsibilities for hiring, training, assessment, and managing performance of staff.
  • Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards.