Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective
Position Purpose: Responsible for connecting with plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS, CAHPS, HOS, Part D and Administrative Operations reports and gap lists with providers. Use existing resources to collaborate
Position Purpose: Leads the integrity and governance of Centenes and/or its vendors corporate ethics and compliance program, and ongoing oversight and analysis of regulatory compliance practices. Key Details: Applicants for this job have the flexibility to work
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Key Details: Must
Position Purpose: Lead the development and execution of business development strategies that expand the companys market presence and drive growth of Individual Coverage Health Reimbursement Arrangements (ICHRAs). Build and strengthen relationships with brokers, employers, and key
Position Purpose: Manage and oversee the coordination of regulatory audits, examinations, and oversight activities for a regional portfolio of Medicaid health plans across the West Region. Provide leadership and direction to team members responsible for day-to-day
Position Purpose: Develop written responses to complex, high-scoring Medicaid Request for Proposal (RFP) section supporting the companys growth and expansion goals. Key Details: Occasional evening and weekend work may be required during peak RFP and re-procurement
Position Purpose: Supports Enterprise Privacy & Security Risk Management (EPSRM) and other teams across Centene by translating complex regulatory, legislative, and contractual requirements into actionable, risk-informed analysis and advisory-ready outputs, among other duties. Serves as a critical
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Key Details: Must be a Board Certified Psychiatrist and licensed in either California
Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides
Position Purpose: Lead sales operations functions, including sales and experience reporting and data management, sales systems oversight and management, broker support, broker and agent commissions and incentive programs, and alignment with finance on sales projections and
Position Purpose: Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports the
*NOTE: We are seeking talented Account Executives in the Raleigh, North Carolina or Richmond, Virginia areas. * Position Purpose: Represent the company to all prospective and existing clients. Monitor client satisfaction and recommend changes to enhance
Pharmacy Technician II (Onsite Specialty Outreach - Customer Service - Phone Outreach with Data Entry) - Houston, TX Position Purpose: Work with the Pharmacists to accurately assist prescription orders in a timely manner Key Job Details:
Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member
*NOTE: We are seeking talented Account Executives in the Raleigh, North Carolina or Richmond, Virginia areas. * Position Purpose: Represent the company to all prospective and existing clients. Monitor client satisfaction and recommend changes to enhance
Position Purpose: Serves as a partner and advisor between enterprise stakeholders and Enterprise Privacy & Security Risk Management (EPSRM), ensuring regulatory and contractual privacy, security, AI, and business continuity requirements are translated into practical operational controls,
Position Purpose: Direct and oversee all training activities, including training assessment and evaluation, material development, and training facilitation. Partner with subject matter experts to develop relevant training programs that may utilize different instructional practices. Lead the
Position Purpose: Identify, negotiate and manage high performing provider and vendor partnerships. Key Details: The Contract Negotiator V delivers significant organizational value by leading complex provider negotiations, strengthening strategic partnerships, supporting affordability and network adequacy goals,
Position Purpose Assist in financial analysis, pricing, and risk assessment to estimate outcomes. Support business decision-making through actuarial analysis, healthcare cost trend evaluation, and the identification of savings opportunities across healthcare data sources. Key Details: This