centene

Position Purpose: Provides technical support to ensure the proper and effective use of clinical information systems and improve the delivery of patient care. Assists users with system navigation, troubleshooting and patient monitoring issues. Collaborates with leaders across functions and discipline

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Key Details: This remote Care Mana

Position Purpose: Strategizes, plans, conceptualizes, configures, and builds complex solutions that solve common challenges within the business, by using technological tools or programs. Conducts extensive research and gathers requirements to determine customer needs and lead and provide oversight o

Position Purpose: Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care Key Details: Make an impact from home as a Remote Psychologist Revie

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 educates members and thei

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: This position is 100% remote with preference to candidates within CST/ EST ti

Position Purpose:Work with the Pharmacists to accurately prepare prescription orders in a timely manner Key Details: Pharmacy Technician II (Specialty Fulfillment - Onsite Mail-order) - Hawthorn, NY. This position is based at Centene's Acaria Health Pharmacy, located at 5 Skyline Drive, Suite 240, H

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 educates members and thei

Position Purpose: Conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care. Analysis of MRA data to identify patterns and development of interventions at the provider and

Position Purpose: Responsible for participating in all phases of the financial system product lifecycle from business problem identification to solution deployment. Responsible for providing the primary functional and technical production support to end users of Centene financial systems. Contributi

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate

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 educates members and thei

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 their families/careg

Position Purpose: Responsible for leading the Finance System Analyst team, overseeing daily operations, ensuring project alignment with business goals, and driving the overall direction of financial systems. Coordinates daily operations and activities of the team. Ensures projects are aligned with b

Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes Monitor business processes and systems to assure integrity and compliance in billing and claims payment Lead teams of analysts to ap

Position Purpose: Serves as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps. This role emphasizes community engagement, member education, and collaboration with providers and internal teams to ensure members receive t

Position Purpose: The Program Manager IV is responsible for all aspects of the planning and delivery of strategic programs and complex, large-scale enterprise-wide projects to execute defined requirements and meet company strategic objectives. This role provides leadership, direction, and hands-on 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 educates members and thei

Position Purpose: Serves as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps. This role emphasizes community engagement, member education, and collaboration with providers and internal teams to ensure members receive t

Position Purpose: Act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care. Establish a community presence, promote Member education, identify and resolve any systemic barriers that limit Members access to appropriate care. Key