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Position Purpose: Support the product teams focus on offering quality, competitive product solutions for growth and retention of our Ambetter marketplace members. Support the annual Product Development Life Cycle for the Commercial Marketplace (Ambetter) products in all states, w
This position has a field component and requires the individual to live in TX. 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
Position Purpose: Tracks and manages the IT (Information Technology) asset life cycle from selection and depreciation to retirement and replacement. Assists in identifying, controlling, recording, reporting, auditing, and verifying configuration items and asset records, including
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: Oversee provider network and contracting related activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Education/Expe
Position Purpose: Manages up-front third party evaluations and relationships with Delegation partners for performance management standards, financial responsibility and proactively implements appropriate business solutions as required. Acts as the critical link between our Delega
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: The Case Auditor ensures accuracy, consistency, and compliance within care management operations by conducting comprehensive audits of case management activities, documentation, and processes. This role supports the organizations mission to deliver high-quality,
This position is a field based role requiring the candidate to live in NJ. 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
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: 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: 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: 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
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
Product Portfolio: Enterprise Integration & Common Core Platforms This executive will lead the strategy, roadmap, and delivery of Centene's Common Core platform portfolio, providing the foundational capabilities that enable enterprise modernization, operational visibility, and s
Position Purpose: Enters, uploads, and posts daily cash receipts and transmits EFT files to banks. Establishes member bank account information for account drafts, sets up new member EFTs, and balances daily receipts with system postings. Performs daily cash receipt reconciliation
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: Oversee and monitor the performance of both internal and external cost recovery and cost containment initiatives according to targeted project metrics and forecasted recovery and cost avoidance goals for each Health Plan. Education/Experience: Bachelor’s degree
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: Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. Key Details: Applicants for this job have the flexibility to work remote from home anywhere in the Continen