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: Provides strategic and clinical leadership for Behavioral Health across all clinical functions (Utilization Management, Care Management, Quality, and Clinical Programs).
Serve as a strategic clinical thought leader for Behavioral Health driving outstanding results in clinical affordability, quality, population health, growth, Net Promoter Score (NPS), and clinical initiatives.
Lead national teams of psychiatrists and psychologists responsible for doctoral-level clinical support to PHCO and the health plans for all three lines of business (Medicare, Marketplace, and Medicaid) for delegated markets.
Focus on driving incremental reductions in avoidable/impactable admissions and readmissions, continuous improvement of HEDIS measures, reduction of unnecessary ER visits, appropriate prescription drug spend, and mitigation of provider abrasion from prior authorization and inpatient management programs.
Collaborate with matrix partners to design, implement, and drive programs that align with and achieve Behavioral Health goals for the product.
Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource allocation and improve operational efficiency.
Identify and deliver relevant clinical and quality KPIs/metrics that are aligned with the strategic direction of the organization.
Serve as a behavioral health subject matter expert on associated healthcare delivery trends and practices.
Engage in regular analysis of medical care cost and utilization data, and partner with key stakeholders to inform and deliver HBR initiatives.
Actively engage with other leaders in the company to ensure an integrated, cross-departmental, data-driven clinical approach to population health for our members.
Support the development and implementation of quality improvement and behavioral health programs to drive value through improved healthcare outcomes and reduced costs.
Develop and maintain relationships with key stakeholders, including providers, payers, and government agencies.
Comply with all policies and standards.
Education/Experience: Medical Doctor (MD) Medical Doctor or Doctor of Osteopathy (DO) required.
Master's Degree Business Administration, Public Health, Healthcare Administration, or related preferred.
7+ years Related experience required.
Board Certification through American Board of Medical Specialists Upon Hire required.
Current state medical license without restriction required.Pay Range: $271,000.00 - $515,500.00 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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