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Vice President, Clinical Program Integration - Remote

Vice President, Clinical Program Integration - Remote

CenteneColumbia, SC, US
2 days ago
Job type
  • Full-time
  • Part-time
  • Remote
Job description

Executive Population Health Integration

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose :

Serves as a primary point of contact and leads the integration of enterprise population health initiatives across multiple local health plans. Ensures local implementation of care management solutions and care models / programs are aligned with national operations and population health goals.

  • Work with Medicare trends to validate opportunity for external care management and utilization management. Will also work with internal population health teams to augment workflows through automation including AI
  • Integrate current and future external population health solutions with internal offering.
  • Implement singular solution for the right member at the right time
  • Monitor monthly performance of external solutions through on-site visits, patient calls, JOCs, Provider meetings, dashboard builds and local health plan collaboration
  • Serve as the Medicare and Duals POC for all external population health solutions
  • Will work across Centene matrix with clinical partnership team, network, local health plans and PHCO
  • Serve as a strategic advisor and primary liaison between enterprise Population Health leadership and local health plans.
  • Partner with health plan leadership to align local care management operations with corporate population health strategies, tools, and workflows.
  • Lead market-level implementation and ongoing maintenance of enterprise population health initiatives, including care management models.
  • Align local market operations with enterprise clinical strategies to improve Starts performance, HEDIS measures, and overall member experience.
  • Provide consultation to Medicare market executives and care management leads on best practices, data insights, and operational enhancements.
  • Drive integration of Social Determinants of Health efforts into local care delivery workflows.
  • Collaborate cross-functionally with Quality, Provider Engagement, Regulatory Affairs, and Utilization management teams to support integrated approaches to member care.
  • Analyze population health and utilization data to identify gaps, trends, and actionable improvement opportunities across markets.
  • Serve as a subject matter expert on population health interventions, including predictive analytics, member segmentation, and care coordination strategies.
  • Deliver regular performance reports and market updates to senior leadership.
  • Collaborate with analytics teams to develop and track KPIs for outreach and engagement activities.

Education / Experience :

Bachelor's Degree Healthcare Administration, Business, Public Health or related field required. Master's Degree Healthcare Administration, Business, Public Health or related field preferred. 10+ years Healthcare strategy, Medicare Advantage, managed care, or a related field. Experience in a matrixed, multi-market organization preferred. Strong expertise in Medicare Advantage plans, CMS regulatory requirements, and health equity principles. Proven track record of supporting field operations through centralized strategy and execution oversight.

Pay Range : $185,200.00 - $352,700.00 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

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Vice President • Columbia, SC, US

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