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.
 

Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States, however it is strongly preferred that selected candidate is located in Indiana. If not located in Indiana, the selected candidate could be asked to relocate.

Position Purpose: Manage all aspects of vendor activity, including but not limited to dental, ancillary, behavioral health, pharmacy and vision vendors for the Health Plan.

Manage vendor utilization including work flows for coordinating services with the Health Plan.Analyze vendor data and complete required reports for the health plan, Corporate and state.Create and manage vendor scorecard and associated ratings/correction plans.Perform as a key account manager for the Health Plan to coordinate with high priority providers and vendors.Coordinate with Corporate Vendor Management team regarding vendor expectations, performance and procedures.Coordinate with various cross-functional departments to educate and communicate expectations, performance and procedures to vendors.Conduct monthly meetings and document discussions, issues, attendees, action items.Research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution.Ensure operation integrity, including compliance with all policies and procedures for the Health Plan including adherence to state contract and guidelinesRequest and/or assist in the development of correction action plans for standards that are not met by the vendor.Performs other duties as assigned.Complies with all policies and standards.

Education/Experience:

Bachelor's degree in Business Administration, Public Administration or related field or equivalent experience.4+ years of healthcare management experience, preferably in vendor managed care or the health insurance field.Experience with reporting and analyzing data preferred. Project management experience a plus.

Pay Range: $84,300.00 - $151,700.00 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