centene

Position Purpose: Provide sales coverage and develop best possible market penetration for all products to present and prospective accounts in his/her assigned territory in accordance with company's policies and programs. Provide greater access to health insurance, by providing education and assistan

Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not avail

Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans. Key Details: Ideal candidate to live in the state of PA. Develop and implement action plans, across all departments affecting assigned products and pla

We are seeking curious, collaborative, and mission-driven graduate students who are passionate about improving healthcare delivery and health outcomes. Interns may contribute to projects across Healthcare Administration, Public Health, Population Health, Health Policy, Quality Improvement, Care Mana

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 Health Benefit Representative (HBR) is responsible for educating and assisting individuals with enrolling in affordable health insurance coverage through the NY State of Health Marketplace. This includes Medicaid (NYM), Child Health Plus (CHP), Essential Plan (EP), Qualified He

Position Purpose: Works with the utilization management team and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline Documents some complex authorization requests and obtain accurate and timely documentation fo

Position Purpose: Perform duties to develop, direct and implement a pharmacy benefit management program. Aid the Vice President of Medical Affairs in formulating and administering related organizational policies and procedures, including pharmacy service quality, pharmacy utilization management and

Position Purpose: Provides comprehensive support to Fidelis and Wellcare members by addressing inquiries, conducting outreach, and assisting with enrollment in various health plans, including Medicaid, Medicare, and other Fidelis Care products. This role requires in-depth product knowledge, consulta

Position Purpose: Provides comprehensive support to Fidelis and Wellcare members by addressing inquiries, conducting outreach, and assisting with enrollment in various health plans, including Medicaid, Medicare, and other Fidelis Care products. This role requires in-depth product knowledge, consulta

Position Purpose: Provides lead level support on on-site and remote technical support to end users and site IT infrastructure (including network, print, audio/video and office setup) by troubleshooting hardware and software problems. Provides expertise in analyzing events and applies expert technica

Position Purpose: Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.

Position Purpose: Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting , as well as designing and programming complex, new processes/reports. Acts as subject matter expert for department or business unit on

Position Purpose: Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/careg

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: Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/careg

Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Per

Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Per

Position Purpose: Serves as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps. This role emphasizes community engagement, member education, and collaboration with providers and internal teams to ensure members receive t

Position Purpose:Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health and substance use. Key Details: This is a remote po