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CARE COORDINATOR III

Centene Corporation
Located in Ohio
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data-type="string"> Description : You could be the one who changes ...
Details
Summary
About the job:
everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. **This role will support our IL Health Plan Medicaid YouthCare program members. This position is fully remote/work from home with 10% travel to local office for quarterly team meetings.** **Applicants must reside in one of the following Illinois counties: Mason, Cass, Greene,...
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Community and Social Service Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Care Manager (RN)

Centene Corporation
Located in Ohio
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data-type="string"> Description : **Position Purpose:** Assesses, plans, and ...
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Summary
About the job:
implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care. **Key Details:** This position serves the NH Health Families Medicaid population. NH RN Licensure is required. Experience in both Physical Health and Behavioral Health is...
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Director, Contracting & Network Development

Centene Corporation
Tallahassee, FL
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data-type="string"> Description : **Position Purpose:** Oversee the ...
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Summary
About the job:
development and implementation of contracting activities in network development and enhancement. + Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between health plan and vendors + Work with business development and providers to develop a strategy for developing new networks including plans to meet network access and unit cost objectives + Determine necessary resources to develop the network and assemble the appropriate team across all business functions. +...
Location:
Tallahassee, FL
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Computer and Information Systems Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Navigator

Centene Corporation
Oklahoma City, OK
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data-type="string"> Description : **Position Purpose:** Develops, assesses, ...
Details
Summary
About the job:
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/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination. **Key Details:** Applicants must reside in Alfalfa, Beaver, Blaine, Canadian, Cimarron, Custer,...
Location:
Oklahoma City, OK
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
High Income Jobs ($80K-$99K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Quality Improvement Specialist (Non Clinical)

Centene Corporation
Located in Ohio
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data-type="string"> Description : **Position Purpose:** Support the ...
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Summary
About the job:
development and maintenance of quality improvement related projects and reporting. Respond to quality improvement inquiries. **Key Details:** Candidates residing in California are strongly preferred and all candidates must be available to work Pacific Time (PST) business hours. Certification as a Certified Professional in Health Care Quality (CPHQ) is preferred. Ideal candidates will have experience with HEDIS, audit processes, and medical records review. + Heavy chart monitoring and auditing of medical records + Monitor the...
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Medical Records Specialists
Career Level / Education:
Postsecondary nondegree award
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Professional in Healthcare Quality
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager, Quality Practice Advisor

Centene Corporation
Oklahoma City, OK
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data-type="string"> Description : **Position Purpose:** The position is ...
Details
Summary
About the job:
responsible for providing leadership and direction for clinical, quality, and risk adjustment functions. Execute on the development and oversight of clinical programs for physician education and communication as well as development of their team in activities to increase member quality of care, reduce costs, and identify risk adjustment opportunities. Provide and analyze reports to identify trends, opportunities and recommend actions. + Coordinates with other departments to prioritize provider engagement, communication...
Location:
Oklahoma City, OK
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Business Analyst II - Claims Coding Triage

Centene Corporation
Located in Ohio
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data-type="string"> Description : **Position Purpose:** Perform various ...
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Summary
About the job:
analysis and interpretation to link business needs and objectives for assigned function. **Key Details:** Prefer candidates who possess a claims coding background with payment integrity and excel experience. Experience with claims coding research and root cause analysis. Remote position. 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,...
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
N/A
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Business Solutions Strategist (ICHRA)

Centene Corporation
Located in Ohio
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data-type="string"> Description : **Position Purpose:** Supports the goals ...
Details
Summary
About the job:
and outcomes of the organization by leading the transformation of our business strategy. Ensures deliverables are met, by assisting with design, execution, and value estimation and realization for initiatives. + Partner with business leaders to identify opportunities for improvement + Drive assessment of business requirements against existing offerings and capabilities to identify and document gaps + Evaluate, assess, and design solutions + Assist in value estimation, cost-benefit analysis, and business case creation +...
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Quality Improvement Coordinator II

Centene Corporation
Located in Ohio
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data-type="string"> Description : You could be the one who changes ...
Details
Summary
About the job:
everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. **Abstractions and Overread experience highly preferred.** **MedSurge experience highly preferred.** **Position Purpose:** Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits....
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Medical Records Specialists
Career Level / Education:
Postsecondary nondegree award
Salary:
N/A
From:
De jobs
Certifications / Licenses:
Certified Professional in Healthcare Quality
Licensed Practical Nurse
Licensed Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

CLINICAL EXTERN

Centene Corporation
Located in Ohio
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data-type="string"> Description : **Position Purpose:** Observe preceptors ...
Details
Summary
About the job:
and participate in various projects to learn and develop skills related to the Managed Care industry. + Develop clinical knowledge and skills by learning about various processes and functions within the Managed Care industry + Observe processes and shadow preceptors to gain hands on experience and become familiar with various clinical services + Follow instructions and procedures provided by preceptor or manager in accordance with company guidelines **Education/Experience:** Current enrollment in an accredited clinical...
Location:
Located in Ohio
Job Type:
Full-Time
Part-Time
Permanent
Occupation:
Physicians, All Other
Career Level / Education:
Doctoral or professional degree
Salary:
N/A
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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