Jobs with Centene

Position Purpose: Perform duties to plan, manage and implement the human resources function for the assigned business unit or location. Knowledge/Experience: Bachelor's Degree in a related area o

Position Purpose: Oversee the maintenance of accurate financial records, including preparing monthly financial reports and various analytical reports. Oversee routine financial analysis; complete co

Position Purpose: Direct multiple business implementation teams simultaneously; and advise the company on standard implementation models, tools and processes. Develop, integrate and operationalize a

Position Purpose: Direct medical management program including utilization management, case management, and quality improvement in accordance with the mission, philosophy, and objectives of the plan a

Position Purpose: To assist the plan in credentialing and re-credentialing providers. Knowledge/Experience: Bachelor's degree in business or healthcare related field or 1-2 years of credentialing

Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or rev

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes. Knowledge/Experience: Bachelor's degree in nursing preferred. At least two years cl

Position Purpose: Perform duties to conduct and manage the day-to-day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily dep

Position Purpose: Receive and respond to member/customer inquiries via telephone and written correspondence in a timely and professional manner. Knowledge/Experience: High school education or eq

Position Purpose: Conduct data analysis to aid in the development, coordination and maintenance of the health plan's pharmacy program. Act as the "go to" person and trainer for other pharmacy depart

Position Purpose: Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State guidelines. Ensur

Position Purpose: Develop candidate pipeline using various sourcing channels and conduct prescreening including phone screens and resume review. Knowledge/Experience: Bachelor's degree in human r

Position Purpose: Assist the health plan in establishing a presence in the community; educate the members about the managed care services provided via the health plan and how to access them; communit

Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues. Perform training, orientation and

This position will support and travel to the following Parishes: Jefferson Plaquemines St. Bernard Orleans Position Purpose: Assist the health plan in establishing a presence in the community; educ

Position Purpose: Responsible for assessing and triaging needs based upon assessments completed for long term and support services, and assisting Members by facilitating their needs, and by providing

Position Purpose: Coordinate the daily work functions of the NurseWise/Nurse Response staff, provide direction and guidance to staff on shift, and investigate and resolve issues. Manage and assign wo

Position Purpose: Provides administrative and staff support to an organizational unit. Knowledge/Experience: Requires a high school diploma with 2-4 years of experience in the field or in a rela

Position Purpose: Provide information and education for inbound and outbound calls; provide oversight and support to the non-clinical staff when they are assisting members/consumers; may act as a lea

Position Purpose: Act as the clinical lead for Case Management and Utilization Review of Health Plan Members for Specialty Therapy Services (Speech Therapy, Occupational Therapy, Physical Therapy) ac

Position Purpose: Develop and maintain databases and processes used to store and analyze customer and operational data. Knowledge/Experience: Bachelor's degree in Information Technology, related

Position Purpose: Provide telephonic disease management services to individual's with coronary artery disease (CAD) and/or heart failure. Knowledge/Experience: Bachelor's degree in related fiel

Position Purpose: Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the ser

Position Purpose: Perform duties to oversee the day-to-day work function of provider services, provide support to staff, investigate and resolve complex issues; exercise cost control and oversee and

Position Purpose: Manage the Provider Data staff. Establish and monitor Key Performance Indicators (KPIs) and responsible for quarterly provider directory completion, online provider directory inte