Centene Corporation is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government-sponsored health care programs, focusing on under-insured and uninsured individuals. Founded as a single health plan in 1984, Centene Corporation has established itself as a national leader in the healthcare services field. Today, Centene works with more than 11 million members in 29 states with government-sponsored healthcare programs and initiatives. Fortune Magazine has ranked Centene Corporation No. 66 in its 2017 FORTUNE 500 list of largest corporations in the United States, ranked by revenue, up from 124th spot last year.
Reporting to the Chief Medical Officer, the Vice President, Medical Management Operations will develop and drive execution of medical management and quality improvement programs, processes, and initiatives to ensure improved outcomes, achievement of health benefit ratio targets, and reduction in administrative costs. This newly created position will foster the adoption of best practices and standardization, while developing customized approaches for unique markets/products, overseeing corporate accreditation, quality improvement, Medical Management Operations (systems, training, auditing, reporting, centralized operations), and new business development and implementation. Participating as an integral leader within the corporate medical management team, this role will be domiciled in St. Louis.
- Master’s degree and ten or more years of operations experience. Strong operational, analytical, and leadership skills. Solid understanding of appropriate metrics, measures, and outcomes, displaying a keen ability to work in a data driven environment.
- Thorough understanding of medical information systems, medical claims payment processes, coding, provider contracting approaches, and case management practices.
- Ability to implement change in a consultative approach and maneuver in a matrix reporting environment. Previous experience managing staff, including hiring, training, managing workload and performance. LEAN/Six Sigma experience preferred.
- Medical management experience would be applicable, but not required. Rather, a strong understanding of managed care operations and change-management mindset would most important aspect in this role.