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: Manage all aspects of vendor activity, including but not limited to dental, ancillary, pharmacy, and vision vendors for Meridian Illinois Health Plan.

***The Manager, Vendor Management position is primarily remote with 10% travel expectation. Since it supports Illinois Health Plan, candidates must reside in the state of Illinois to be considered for the position. ***

Responsibilities:

Manage vendor utilization including workflows for coordinating services with the Illinois Health Plan
Analyze vendor data and complete required reports for the health plan, Corporate and state
Create and manage vendor scorecard and associated ratings/correction plans
Perform as a key account manager for the Illinois Health Plan to coordinate with high priority providers and vendors
Coordinate with Corporate Vendor Management team regarding vendor expectations, performance, and procedures
Coordinate with Medical Management, Member Services and Provider Services to educate and communicate expectations, performance and procedures to vendors
Conduct monthly meetings and document discussions, issues, attendees, action items, research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution
Receive and respond to provider related database information requests and concerns
Ensure operation integrity, including compliance with all policies and procedures for the Illinois Health Plan including adherence to state contracts and guidelines
Request and/or assist in the development of correction action plans for standards that are not met by the vendor

Education/Experience: Bachelor's degree in public health, business or related field or equivalent experience. 4+ years of healthcare management experience, preferably in vendor managed care or the health insurance field. Experience with reporting and analyzing data preferred. Strong Excel skills and working with a variety of software data programs preferred. Project management experience a plus.

Pay Range: $86,000.00 - $154,700.00 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, 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