Centene Corporation, a Fortune 100 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Centene serves more than 12 million members through programs and services to government sponsored healthcare programs. Centene is seeking a Senior Vice President of Medical Management Operations to lead a team of 700 in the Medical Management department for a health plan that covers 3 million lives.
The SVP, Medical Management Operations will oversee and coordinate the Utilization Management and Case Management functions, engage with senior leaders in setting strategy and driving results, and lead integration efforts, including in-sourcing case management and completing a systems conversion. This nurse executive will establish systems and processes that drive accountability for financial and operational outcomes. The successful candidate will be one who has run a medical management operation successfully, and who is detail oriented, meticulous in managing reports and data, and who knows how to engage and develop employees.
- Bachelor’s Degree in nursing or a related field. Master’s Degree strongly preferred.
- Ten or more years of related medical management experience with a proven record of accomplishment in hitting financial, operational and quality targets.
- Working knowledge of UM and CM practices, managed care, and Medicaid programs.
- Willingness to travel between Northern and Southern California at least once per month, depending on team needs, and travel to St. Louis a minimum of twice each year.
- Detail-oriented and meticulous mindset, with strong report and data management skills.
- A leader of a large department, but also an operator and a “doer” in nature rather than just a “thinker.”
- Ability to engage and develop employees.
- Experience with UM and CM platforms/systems conversion and implementation, analytical skills and Six Sigma experience preferred.
- Previous experience with plan operations, quality improvement practices and development of strategic initiatives to enhance plan’s performance.
- Solid understanding of appropriate metrics, measures, and outcomes, displaying a keen ability to work in a data driven environment.