Centene is transforming the health of our communities one person at a time.  As an Executive on our team, you could be the one who changes everything for our 28 million members.
 

This position is responsible for the oversight of Enterprise Population Health & Clinical Operations (PHCO) Care Management programs to include Medicare and Duals populations.

Establish the business unit’s clinical strategic vision, objectives, and procedures to ensure delivery of cost effective, clinically appropriate services in all productsEstablish the organization’s focus and direction regarding models of care that incorporate needs of all lines of business, focusing on quality and operational efficiencies across the organization.Plan, develop, and drive execution of medical management and quality improvement programs, processes, and initiatives to ensure improved quality outcomes, achievement of Quality & Affordability targets,Drive discipline, consistency, and execution of standardized initiatives and best practicesFacilitate integration for Medicare Duals StrategyUtilizes data sources to develop and implement PHCO strategies to be inclusive of integrated clinical care models to drive valueOversee the development and implementation of care management processes to ensure NCQA, URAC, and HEDIS measuresDevelop and implement standardization in measuring and monitoring operational and outcome metricsIdentify trends between Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Member Engagement; create programs/pilots to improve engagement with strategic partners.Monitor performance results against established metrics and benchmarks and recommend improvement opportunitiesResponsible to realize affordability across all programs and marketsNavigate in a matrixed environmentRequires collaboration with Health Plan Executive Leadership teams

Education/Experience:

Bachelor's degree with 5+ years of relevant experience. Previous experience in a managed care organization strongly preferred. 3+ of leadership experience. Master's Degree preferred.

Preferred candidates will have previous experience working at enterprise or regional levels or have experience in a large health plan.

License/Certification: Current state RN license preferred.


 

Pay Range: $182,100.00 - $345,600.00 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