Vice President, Phco & Utilization Management

Centene

Remote
Base: $250,000 - $480,000; bonus/equity: not speci...
Hybrid
Medical management programs
Quality improvement initiatives
Managed care practices
Plan, develop, and drive execution of medical management and quality improvement programs to ensure improved quality outcomes, achievement of health benefit ratio targets, and reduction in administrative costs

Job Summary

  • Plan, develop, and drive execution of medical management and quality improvement programs to ensure improved quality outcomes, achievement of health benefit ratio targets, and reduction in administrative costs.
  • Oversee corporate accreditation, quality improvement, medical management operations and new business development and implementation, including Clinical Prior Authorization and Health Supports teams.
  • Develop and implement business plans to leverage technology and standardize training, auditing, and work processes to increase effectiveness and efficiency.

Matching Summary

Plan, develop, and drive execution of medical management and quality improvement programs to ensure improved quality outcomes, achievement of health benefit ratio targets, and reduction in administrative costs.

Salary

Base: $250,000 - $480,000; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • Medical management programs
  • Quality improvement initiatives
  • Managed care practices
  • Utilization management
  • Care management
  • Clinical information systems

Nice-to-have

  • Customized market approaches
  • Drive discipline and consistency
  • Leverage technology for efficiency
  • Integrate health plans and specialty companies

Key Requirements

  • Bachelor's Degree in business or healthcare
  • Master's Degree strongly preferred
  • 10+ years healthcare experience
  • Strong financial acumen
  • Operations experience preferred
  • Proficient in project management tools
  • Continuous process improvement methodologies
  • Six Sigma certification strongly preferred

Work Rights

Not specified

Tailored Resume

Cover Letter