You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on
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
Position Purpose: Responsible for leading the integration, modernization, and efficient operation of Centenes enterprise telephony and contact center platforms. Involves close collaboration with business process owners, external technology vendors, and Business Technology Systems professionals to align telephony
Position Purpose: Plan and drive execution of Medical Management utilization programs, processes, and initiatives to ensure achievement of health benefit ratio targets, and appropriate reductions in utilization related expenses. Provide vision and strategic leadership for the
Position Purpose: Directs the utilization management team to ensure the appropriate application of policy procedures and processes to help support best member outcomes. Oversees and manages Utilization Operations specific to the daily operations of Utilization Management
Position Purpose: Performs reviews of members care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of members care in accordance with ABA guidelines. Key Details:
Position Purpose: Performs reviews of members care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of members care in accordance with ABA guidelines. Key Details:
Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate. Key
Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members
This is a remote position and can be located anywhere in the US. Position Purpose: The Duals Strategy and Policy Advisor will work with Centene associates across the company in developing and executing the Duals Integration Offices
This is a remote position and can be located anywhere in the US. Job Description: Responsible for oversighting leading and driving end-to-end program management, developing national duals strategy, including Medicare Advantage and Duals related public policy
Position Purpose: Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues related to member care, provider interactions, and facilitates operations within
Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. Join our People Business Partner team and learn more about Human Resources
Position Purpose: Oversees the care plans / service plans and care management activities of member needs to provide quality, cost-effective healthcare outcomes. Reviews and provides expert knowledge to inform personalized care plans / service plans for