Company: Oklahoma Complete Health
Posted on: November 18, 2023
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.
Oklahoma Complete Health, a Centene company, is committed to
providing quality healthcare solutions to transform the health of
At Oklahoma Complete Health, we are community advocates and
change-makers in search of an inclusive culture grounded by our
commitment to work-life balance, competitive compensation, and
continuous career development. Join us and be a part of a
collaborative, growing network of innovative thinkers delivering
solutions at the local level.
***Must Reside in Oklahoma***
Position Purpose: Coordinate, negotiate and handle activities of
the provider contracting, network development and/or provider
relations functions and aid in formulating and administering
organizational policies and procedures. Negotiate large hospital,
physician groups and ancillary service agreements in accordance
with Corporate, health plan and government regulations and
Oversee provider contracting activities to ensure efficiency and
maintain compliance with Company policies and standards, government
laws and regulations
Negotiate contracts with hospitals, physician groups and ancillary
Develop and implement a network development plan for the assigned
region and set of providers and identify and initiate contact with
potential providers in support of the Company's strategic goals and
Effectively integrate new programs and strategies to reach per
member per month targets, and provide oversight to the provider set
---up and contract configuration in the computer system to ensure
accurate claims adjudication
Perform basic financial analyses to identify medical cost
improvement opportunities, develop strategies to reach financial
goals, and execute contracting strategies to meet goals and
Evaluate and monitor providers' performance standards and financial
performance of contracts
Education/Experience: Bachelor's degree in Business Administration,
Health Care Administration, related field or equivalent experience.
5+ years of related experience negotiating hospital, large
physician groups and ancillary service agreements and external
customer service for providers. Experience in marketing/sales,
medical economics in a managed care or insurance environment.
Previous management experience including responsibilities for
hiring, training, assigning work and managing performance of staff.
Experience in provider network management, Medicaid/Medicare
contracting, and/or claims processing preferred.
License/Certification: Valid driver's license
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
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.
Keywords: Oklahoma Complete Health, Midwest City , Director, Contracting, Executive , Shawnee, Oklahoma
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