Director, Strategic Provider Partnerships Job at Ohana Health Plan, Waipahu, HI

U01WTmpJck9zTUxpNGV5UjZrd1pwMnhRZGc9PQ==
  • Ohana Health Plan
  • Waipahu, HI

Job Description

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: Lead provider and health plan strategy related to performance improvement on cost, quality, coding and member outreach and engagement. Responsible for ongoing review of performance reporting and data, interpreting and prioritizing results; utilize tools and resources to identify performance insights; work with health plan and provider functional leadership to present results and recommend actions to providers. Manage provider performance in all levels of value-based agreements, including quality & utilization pay for performance and risk contracts.

Remote but must reside in Hawaii.

  • Develop provider performance improvement strategy at the plan and provider levels
  • Analyze and interpret cost and quality data to determine performance insights and prioritize provider actions
  • Facilitate joint operating committee (JOC) performance discussions and work cross-functionally to build consensus on priorities and actions to improve performance
  • Present financial, medical cost and quality performance data to provider leadership
  • Support value-based contract negotiations through the contract value and support model
  • Provide high-level recommendations to providers and health plan leadership regarding opportunities to optimize clinical workflow to increase member outreach and care coordination
  • Understand member population and provider variation by line of business to most effectively support providers with performance improvement
  • Develop proficiency in tools and value based contracting and educate providers on the use of tools and interpretation of data

Education/Experience: Bachelor’s Degree in Healthcare Administration, Business Administration, or similar field; Master’s degree preferred. 7+ years of experience in managed care, value-based contracting, or clinical experience.

Pay Range: $103,500.00 - $191,600.00 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. 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.

Job Tags

Holiday work, Contract work, Remote job, Flexible hours,

Similar Jobs

Hilton

Room Attendant - DoubleTree by Hilton Hotel Kansas City Overland Park Job at Hilton

 ...Exciting opportunity at DoubleTree by Hilton Hotel Kansas City - Overland Park! We are seeking a housekeeping professional to join our dynamic team as Room Attendant. If you have a passionate about cleaning and creating memorable experience for guests, this is the role... 

BAE Systems USA

Material Handler II Job at BAE Systems USA

 ...-paced, dynamic environment with the use of automated retrieval systems. Key Responsibilities: 1. Material Handling and Movement:...  ...growth opportunities in a dynamic and growing company. About BAE Systems Electronic Systems BAE Systems, Inc. is the U.S. subsidiary... 

Game Day USA

Remote Live Chat Agent Work From Home Job at Game Day USA

 ...a friendly, detail-oriented Remote Live Chat Agent to provide real-time customer support through...  ...experienceall from the comfort of your home.This role is ideal for someone who...  ...Reliable high-speed internet and a quiet work environment.~Ability to multitask and manage... 

Catalytic Solutions

Travel Infusion Center Registered Nurse Job at Catalytic Solutions

 ...Job Description Catalytic Solutions is seeking a travel nurse RN Infusion for a travel nursing job in St Johnsbury, Vermont...  ...nCoordinate Clinical and Administrative OperationsManage scheduling, prior authorizations, and clinical order reviews, while maintaining effective... 

PowerToFly

Deals - Financial Due Diligence, Senior Manager (San Francisco) Job at PowerToFly

 ...At PwC, our people in deals focus on providing strategic advice and support to clients in areas such as mergers and acquisitions, divestitures...  ...professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence...