Director, Contracting & Network Development

Company: Tennessee Health Plan
Location: Brentwood
Posted on: February 1, 2025

Job Description:

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.

Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.

• Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit's policies and standards, government laws and regulations
• Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
• Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
• Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
• Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ability to travel 10-25%
  Education/Experience: Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience. 7+ years of combined contracting, network development or provider relations experience. Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements. Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff. License/Certification: Valid driver's license.
  
  This position is remote within the state of Tennessee. Candidates must reside in the state of Tennessee in order to be considered. 10-25% in state travel required.
  
  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

Keywords: Tennessee Health Plan, Smyrna , Director, Contracting & Network Development, Executive , Brentwood, Tennessee