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Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their fami
Position Purpose: The Senior Business Process Consultant leads business case development for proposed initiatives, supports the strategic planning process, and leads larger scale, cross-functional initiatives. Key Details: Must be authorized to work in the U.S. without the need
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.
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 impr
Position Purpose: Conduct analysis, pricing, and risk assessment to evaluate and project Medicare Advantage financial performance. As part of the Medicare Actuarial Forecast & Financial Performance Team, this role supports quarterly forecasting, Medicare bid target setting, and k
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
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
Position Purpose: The Community Relations Specialist is responsible for leading activities to achieve membership/enrollment goals through various means including, but not limited to, marketing projects and new market initiatives, health fairs and community activities, training, m
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
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
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 improve
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: 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 b
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. Posi
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. Posi
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 ke
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 dis
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. Posi
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. Serve as Cl
- Develop and oversee the model for managing product development strategy. - Develop and oversee product roadmap in alignment with company strategic goals, market trends, competitive landscape, client, and consumer needs. - Drive digital and data/analytics product innovation en