centene

Position Purpose: Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care giv

Position Purpose: The Clinical Pharmacist processes review prior authorization requests for non-formulary medications for clinical appropriateness. This assures members receive the most effective and cost effective pharmacological therapies. Key Details: Must be authorized to work in the U.S. withou

Position Purpose: Provide strategic and operational insights to senior leadership to drive the key initiatives and growth plans in the market. Collaborate with Corporate Strategy partners to ensure alignment with broader organizational Initiatives. Act as a key resource for information gathering and

Position Purpose: The Senior Manager of Credentialing and PDM will oversee all direct processes of credentialing and provider data entry, from triage through provider enrollment and data maintenance. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa spons

Position Purpose: Responsible for supporting accounting operations through financial reporting, reconciliations, account analysis, and month-end close activities while ensuring accuracy, compliance, and timely completion of accounting processes. Key Details: Candidates must have a Bachelor’s degree

Position Purpose: Enables the strategy and execution of communications and change outcomes as it relates to the successful execution of strategic initiatives in the transformation portfolio. Ensures leadership behaviors and culture are linked to all aspects of transformational change. Key Details: M

Position Purpose:Lead the development, coordination, and execution of operational strategies and process improvements across shared services to support enterprise and market‑level product growth, implementation, and performance objectives. Translates strategy into operating plans, facilitates cross‑

Position Purpose: Lead external relations activities in Kansas in accordance with Centene, health plan, government, and contractual guidelines. Develop and maintain relationships with legislators, county governments, associations, and other key stakeholders to monitor, influence, and advance healthc

****Position requires candidate to live within the state of Michigan**** Position Purpose: The Director of Government Affairs is responsible for coordinating state government relations and legislation for the Department of State Government Relations and assists the Department of Legislative and Regu

Position Purpose:Provide communications and content marketing expertise to support internal and external communications, content strategy, and stakeholder engagement initiatives. Manage the editorial cycle from content creation through delivery for written communications, marketing materials, and ca

Position Purpose: Develop and produce marketing materials and coordinate website changes. Provide support to implement the strategic public relations and communication plan for the organization. Work closely with Senior Management to implement strategic communications plan and marketing initiatives

Position Purpose: Audit medical records to identify inappropriate billing practices and recommend next steps through extensive review of claims data, medical records, corporate policy, state/federal policy, and practice standards. Key Details: Preferred qualifications include coding certification, n

Position Purpose: Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members. Engage with providers to align on network performance opportunities and solutions, and

Position Purpose: Conduct strategic analysis, peer review, build and support tools to aid in planning processes, pricing, and assess risk to estimate financial outcomes. Provide expertise and technical support in matters related to the successful and financially sound operations of the company's bus

Position Purpose: Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to our members. Engage with providers to align on network performance opportunities and solutions, and

The Care Manager will be responsible for enrolling members in case management and completing required care management activities for individuals of all ages. The role requires strong communication, organization, and care coordination skills to ensure members receive appropriate support based on thei

Position Purpose: Conduct strategic analysis, pricing, peer review, build and support tools to aid in planning processes and assessing risk to estimate financial outcomes. Manage actuarial needs and produce actuarial reports to aid in developing corporate strategy. Key Details: Candidates must have

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 Details: This is a remote position working Monday through Fri

Position Purpose: Ensure regulatory compliance with Washington state and other government agencies related to the health insurance industry, Centene Corporation, and its business subsidiaries. Key Details: Candidates must reside in the state of Washington and be willing to travel throughout the stat

Position Purpose: Provide consultative support to providers to improve their performance on member outreach, utilization management, cost, quality and risk. Discuss, analyze and interpret performance reporting, member engagement data and other data resources to identify opportunities for improving m