centene

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 primarily remote

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: 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: 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 is a remote posi

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 telephonically or through hom

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: Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program. Key Details: Remote Pharmacy Coordinator role supporting Eastern Time business hours, Monday through Friday from 8:30 AM to 5:00 PM. Thi

Position Purpose: Design, implement and maintain training resources. Evaluate, propose, and create training programs supporting customer service, technical process documentation, operational systems, and e-learning development for Corporate Member and Provider Services training. *** The Senior Curri

Position Purpose: Responsible for the overall coordination of the office facilities and support services while providing administrative support to the entire location. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Spo

Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function. This position supports member communications by gathering, analyzing, and documenting business requirements; evaluating data and system dependencies; and translating approved bu

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: Identify market trends and oversee functions of quality improvement programs for HEDIS, CAHPS, and/or HOS strategy and related quality improvement activities. Assists stakeholders to determine their business issues and recommend solutions to drive business value. Analyze stakeholde

Position Purpose: Manages the care management team and the care coordination of behavioral health members to develop and assess high quality, cost-effective healthcare outcomes related to mental and behavioral health needs. Manages escalations and care management issues related to members or provide

Position Purpose: The Recovery Analyst identifies, researches and investigates possible claims overpayments to support the Claims Recovery function. Key Details: 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

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate. Key Details: This fully remote role supports Oregon Medicaid by c

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: Provides leadership and direction in planning, developing, and maintaining Centene's IT service operations function. Provides oversight to the major enterprise system management and event management tools, and their respective maintenance. Leads ITSM strategies, including collabora

Position Purpose: Plays a critical role in advancing Data Loss Prevention (DLP) program maturity by contributing to strategy, guiding solution design, and reducing enterprise data loss risk. Operates with a high degree of independence, discretion, and professional judgment. Applies advanced data pro

Position Purpose: Manages the team members accountable for designing, developing, and implementing complex enterprise software solutions. Collaborates closely with technical and non-technical roles such as data modelers, architects, business analysts, data stewards, and subject matter experts (SMEs)

Position Purpose: Collaborate with healthcare providers to help them achieve high performance with their value based contracts. Key Details: 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