centene

Position Purpose: Responsible for the operation, maintenance, and continuous improvement of enterprise data security technologies that protect and govern sensitive data. This role independently resolves technical issues, implements new capabilities, and drives operational improvements that strengthe

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. Perf

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 outreach telephonically or through hom

Position Purpose: Performs care management duties to assess, plan and coordinate aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality and cost effective care. Completes medication review for pre-admission and post-discharge reconciliat

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: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 Hea

This is a remote position that can be located anywhere. Position Purpose: Oversee the maintenance of accurate financial records and financial analytic functions. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorsh

Position Purpose: The HR Program Manager III is responsible for leading and executing business-critical talent initiatives that support organizational priorities and workforce transformation. This role oversees the design, implementation, and continuous improvement of leadership development programs

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 education fo

Position Purpose:Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professio

Position Purpose: Oversee the product development function, including formulating product vision and strategy, defining future product needs and enhancements, and driving the creation of profitable, highly engaging, easy-to-use products across all business units. Develop and oversee the model for ma

Position Purpose:Lead the development and execution of business development strategies that expand the company's market presence and drive growth of Individual Coverage Health Reimbursement Arrangements (ICHRAs). Build and strengthen relationships with brokers, employers, and key stakeholders; ident

Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records, provider information, and other relevant evidence to identify potential misconduct and support case resolution. Document investigative activities, prepare reports and referral

Position Purpose: Develop written responses to complex, high-scoring Medicaid Request for Proposal (RFP) section supporting the company's growth and expansion goals. Key Details: Occasional evening and weekend work may be required during peak RFP and re-procurement periods. Clinical healthcare exper

Position Purpose: The Senior IAM Engineer designs, develops, implements, and supports enterprise Identity and Access Management solutions. This role operates as an independent technical expert and combines strong IAM engineering depth with a developer mindset. The engineer must be able to understand

Position Purpose: Assist the Vice President of Medical Affairs to direct and coordinate the medical affairs functions for the business unit. Oversee the denials and appeals department. May manage other medical directors. Assume VPMA responsibility in absence of VPMA. Key Details: Serve as Clinical E

Position Purpose: Lead the development, implementation, and ongoing optimization of Medicaid benefit programs and supporting vendor solutions throughout the product life cycle. Partner with regional Medicaid markets to translate member needs, regulatory requirements, and market priorities into diffe

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 available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Establi

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 available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Establi

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 available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Establi