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Centene CorporationCC

Analyst, Value Based Payment Initiatives

Centene Corporation is a leading healthcare enterprise committed to transforming the health of communities through high-quality and affordable healthcare solutions.

Centene Corporation

Employee count: 1001-5000

Salary: 55k-99k USD

United States only

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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Analyst of Value Based Payment initiatives will assist in the execution of the organizations Value Based Payment contracting strategies (VBP). This position will be responsible for working with the VBP AVP, VBP Managers and other cross functional teams in the management of multiple VBP relationships including Provider Groups (IPAs) and the other contracting entities like ACOs and potentially DSRIP PPSs.

  • Work collaboratively with Contract Management to design and refine, the VBP contract negotiated with each assigned VBP Provider Group partnership.
  • Accurately and effectively communicate the status of each VBP relationship to the VBP team and other cross-functional leads.
  • Recommend reporting enhancements based on VBP partner feedback and needs identified through regular use of the existing reporting tools.
  • Appropriately prioritize and escalate VBP issues to the AVP and Managers of VBP Initiatives.
  • Work with the Manager / Lead of each VBP partner to develop strategies and action plans designed to eliminate any aberrant utilization and or quality of care patterns that will prevent the VBP partner from having a successful outcome through its Fidelis VBP relationship.
  • Assist internal and external VBP meetings (clinical, IT, legal, etc ) in order to resolve any issues related to the operation of those VBP relationships that have been assigned.
  • Assist in tactical execution of the business plan objectives to drive success of each VBP relationship.
  • Assist in building and maintaining relationships with key individuals at assigned PPS organization and their related VBP contracting entities.
  • Act as a subject matter expert on all VBP related matters.
  • Assist in implementation for VBP assigned relationships including third party vendors.
  • Provide daily assistance in the management of VBP activities, including data analysis, problem resolution and other activities to assist in the facilitation of a successful relationship with assigned Provider Group Partners.
  • Performs other duties as assigned.
  • Complies with all policies and standards.
The VBP Strategy:
  • Is consistent with the New York State Roadmap For Medicaid Payment Reform (the Road Map).
  • Incorporates incentives that encourage providers to improve the quality and effectiveness of the services they provide while simultaneously reducing their unnecessary use of delivery system resources.
  • Does not disrupt the organization's preexisting relationships with any provider partners.
  • Results in aggregate quality and financial outcomes that are consistent with the organization's objectives.

Education/Experience: BA/BS – Bachelors Degree Required. MBA/MHA/MPH Preferred. Graduate education in health care administration or other related areas preferred. Minimum of 1-3 years of relevant healthcare operation or policy experience. Communicate with technical and business constituencies effectively. Experience in writing business specifications and requirements. Knowledge of Financial, Asset Management, and Expense modules.Pay Range: $55,100.00 - $99,000.00 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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

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Full Time

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Entry-level
Mid-level

Salary

Salary: 55k-99k USD

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United States +/- 0 hours

About Centene Corporation

Learn more about Centene Corporation and their company culture.

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Centene Corporation is a leading healthcare enterprise dedicated to transforming the health of the communities it serves, one person at a time. Founded in 1984, Centene operates as a Managed Care Organization that provides access to high-quality healthcare solutions. The company serves a diverse population of over 28 million members across the United States by offering affordable and comprehensive healthcare services tailored to the unique needs of each individual. With a strong focus on Medicaid, Medicare, and the Health Insurance Marketplace, Centene remains committed to improving healthcare outcomes while ensuring that its programs are culturally sensitive and responsive to the communities served.

Centene's evolution began as a nonprofit Medicaid plan in Milwaukee, Wisconsin, founded by Elizabeth "Betty" Brinn, a former hospital bookkeeper who recognized the challenges faced by low-income individuals in accessing adequate healthcare. Under the leadership of CEO Sarah M. London, the company has expanded its reach through organic growth and strategic acquisitions, reaffirming its position as the largest Medicaid managed care organization in the U.S. Furthermore, Centene emphasizes local healthcare delivery by employing professionals who reflect the diversity of the populations they serve, ensuring individuals receive personalized care that meets their needs. Centene is also dedicated to corporate sustainability, focusing on removing health-related barriers and enhancing health equity through its community-driven initiatives.

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Centene Corporation

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Centene Corporation hiring Analyst, Value Based Payment Initiatives • Remote (Work from Home) | Himalayas