Collaborates with Provider Oversight, Health Services, State Health Programs, Medicare leadership and Network Management to monitor capacity and performance of contracted medical groups and long-term services while supporting healthcare, social services and behavioral health providers to ensure goals are met.
Responsible for accurate analysis and assessments of care quality and access by members. Supports identification, development and monitoring of business performance improvement plans as necessary.
Facilitates complex problem resolution between providers and vendors within the delivery system and internal operations.
Responsible for keeping abreast of business needs and issues related to systems and performance success and satisfaction of members and providers by maintaining ongoing interaction with internal operation units.
Serves as project leader for large scale, cross-functional initiatives to drive performance improvement, financial gains, customer satisfaction and improved compliance.
Organizes work teams to accomplish project work: including identification and confirmation of participants, establishment of project plan, consistent work team engagement and productivity, meeting facilitation, consensus building, recommendation documentation and implementation oversight.
Performs detailed analysis of data, workflows, policies, procedures, organization of staff, and skills in order to execute initiatives. Investigates and validates improvement opportunities.
Oversees the support of established internal and external committees by organizing and publishing agendas, documenting minutes, maintaining work plans, performing follow up and preparing and publishing reports.
Manages project plan and ensures team members deliver work with agreed-upon schedules.
Supports project work by utilizing project management software or other approved tools.
Serves as primary business POC on assigned projects; collaborates with PPMO and other Project Managers as necessary.
Prepares communications and presentations to all levels of the organization as well as external audiences.
Assists in building process improvement and project management skills and serves as project leader for large scale, cross-functional initiatives.
Provides effective leadership to staff, with particular attention to recruitment, mentoring and ongoing leadership to make a great work environment.
Travel ability Under general direction of the VP Provider Performance and Analytics, the Director Delivery Systems Operations and Performance Management will be responsible for organizing, managing, driving work to conclusion and maintaining performance levels related to health care delivery (including medical management, provider network management and behavioral health services) for Provider systems.
Essential to success in this role is proven ability to execute in highly matrix supported environment.
The Director Delivery Systems Operations and Performance Management must be capable of managing two or more mid-sized, cross-functional projects (15 participants and/or $500k budget).
Bachelor's Degree in Business or related field required.
5-7 years experience supervising staff and/or coordinating large, multifunctional project teams.
Minimum 7 years project management or equivalent experience leading cross-functional initiatives in complex organizations.
License/Certification: Project Management Certification preferred
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.