Vice President, Payment Innovation & Value-Based Contracting

📋 Description

• • Centene Corporation is seeking a visionary and strategic leader to join its executive team as the Vice President, Payment Innovation & Value-Based Contracting. This pivotal role is responsible for shaping and executing the enterprise-wide strategy for Value-Based Contracting (VBC) and payment innovation, aiming to significantly enhance the quality, affordability, and outcomes for Centene's 28 million members.
• • As the Head of Payment Innovation, you will be instrumental in advancing innovative payment models that not only improve clinical quality and member health outcomes but also drive provider performance and cost efficiency. Your work will be crucial in aligning these initiatives with Centene's overarching enterprise network strategy, specific line of business priorities, unique state-level needs, and stringent regulatory requirements.
• • This executive position demands close collaboration with key stakeholders across the organization, including Network Development, Actuarial, Clinical Operations, Quality Improvement, Product Management, Finance, and Health Plan leadership. Through these partnerships, you will develop, implement, and scale sophisticated payment models, foster widespread adoption, and ensure demonstrable improvements in the cost of care and clinical performance metrics.
• • You will lead a dedicated, cross-functional team comprising VBC strategists, model designers, and performance analysts. In this capacity, you will serve as Centene's foremost subject matter expert on payment innovation, guiding the organization's approach to evolving healthcare reimbursement.
• • Key responsibilities include defining and executing a national VBC and payment innovation strategy that directly supports enterprise growth objectives, strengthens network strategy, and aligns with product development priorities.
• • You will ensure that all payment innovation initiatives are seamlessly integrated with and contribute to the enterprise's overarching goals related to managing the cost of care, enhancing quality performance, and fostering robust provider engagement.
• • A core function of this role is to lead the development and standardization of enterprise-wide payment models. This includes designing and implementing a variety of arrangements such as shared savings, capitation, bundled payments, episode-based payments, and quality-incentive programs.
• • You will be responsible for establishing scalable frameworks, standardized contract templates, and comprehensive playbooks that facilitate consistent national execution while allowing for necessary market-level flexibility.
• • This role owns the performance of the enterprise VBC portfolio, meticulously tracking and analyzing financial impacts, utilization patterns, quality outcomes, and provider performance to drive continuous improvement.
• • You will partner closely with Medical Economics, Actuarial, and Analytics teams to establish clear performance measurement standards and develop executive-level reporting dashboards that provide actionable insights.
• • A critical aspect of the role involves embedding payment innovation strategies directly into enterprise and market-level network contracting and negotiation processes, ensuring that payment models are a lever for achieving strategic objectives.
• • You will influence enterprise-wide prioritization and investment decisions by providing a strategic perspective informed by payment innovation opportunities and best practices.
• • The position requires a deep understanding of the healthcare landscape, including various market segments such as Medicaid, Medicare (including Medicare Advantage and Dual Eligible Special Needs Plans), and commercial insurance.
• • You will champion the adoption of advanced payment methodologies that align financial incentives with the delivery of high-quality, cost-effective care, ultimately benefiting Centene's diverse member population.
• • This role offers a unique opportunity to drive transformative change in healthcare payments, impacting millions of lives and contributing to Centene's mission of improving health outcomes in the communities it serves.
• • The flexibility to work remotely anywhere in the Continental United States makes this an accessible opportunity for top talent nationwide.