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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 telephoni
Position Purpose: Coordinate and negotiate hospital, physician (IPAs, PPMs, individual providers, multi-specialty groups) and ancillary service agreements that are in accordance with corporate, health plan and State guidelines. Key Details: Must be authorized to work in the U.S.
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 educa
Position Purpose: Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and corporate teams to meet business unit and corporate strategic objectives. Educatio
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 care. Develops
We are seeking curious, innovative, and motivated students who are eager to gain exposure to a wide range of corporate business functions that support Centene's mission and enterprise strategy. Interns may contribute to projects across Human Resources, Communications, Marketing,
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 Pla
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 care. Develops a personalized car
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-d
Position Purpose: Represent the company to all prospective and existing clients. Monitor client satisfaction and recommend changes to enhance satisfaction. Key Details: Due to travel requirements of the role, we are seeking candidates who live within an hour of Raleigh, North Ca
Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. We are seeking curious, analytical, and detail-oriented students who are interested in using data to e
Position Purpose: Lead provider network strategy, development, contracting, and performance management across Missouri. Assess market and provider performance, identify network and cost improvement opportunities, develop market strategies, and lead complex negotiations with hospi
Position Purpose: Assist in financial analysis, forecasting, pricing, and risk assessment activities that support Medicare Advantage financial performance. Key Details: Fully remote within the Continental U.S. Requires actuarial experience and progress toward an actuarial creden
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
Position Purpose: Oversee implementation of assigned programs and lead the development of program initiatives to improve and monitor service delivery and outcomes for assigned populations. Key Details: Must be authorized to work in the U.S. without the need for employment-based
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 opportuni
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
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
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 care. Develops
Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of member's care in accordance with ABA guidelines. Key Details: Must