Head of Provider Operations

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.
 

Position Purpose:
The Head of Provider Operations will be responsible for overseeing and managing all aspects of provider data management, credentialing, market service excellence, and the provider task force. This role requires a strategic leader with a strong background in healthcare operations and a commitment to ensuring the highest standards of service and compliance.

• Oversee the accurate and timely management of provider data, ensuring data integrity and compliance with regulatory requirements.
• Lead the credentialing process for providers, ensuring that all credentials are up-to-date and meet the necessary standards.
• Drive initiatives to enhance service excellence in the market, focusing on improving provider and patient satisfaction.
• Lead and coordinate the provider task force, ensuring effective communication and collaboration among team members to achieve organizational goals.
• Ensure strict compliance with healthcare regulations, policies, and procedures.
• Lead the adoption of best practices and standard operating procedures.
• Monitor key performance indicators (KPIs) and spearhead performance enhancements.
• Address and resolve operational challenges, implementing corrective actions as necessary.
• Build and maintain robust relationships with healthcare providers, payers, and other stakeholders.
• Demonstrate strategic thinking and problem-solving abilities, possess strong analytical skills with a high level of attention to detail, be proficient in data management and credentialing software, and have excellent interpersonal and negotiation skills.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor's Degree in business administration, healthcare management, or related field required
• Master's Degree in a related field preferred
• 10+ years experience in healthcare operations required
• 5+ years management experience with excellent leadership, communication and organizational skills required
• Strong knowledge of provider data management and credentialing processes required
• Ability to work collaboratively with cross-functional teams and stakeholders 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, 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