Browse current Centene Corporation openings that JobDrop found directly from the company's careers source.
Position Purpose: Provides lead level support on on-site and remote technical support to end users and site IT infrastructure (including network, print, audio/video and office setup) by troubleshooting hardware and software problems. Provides expertise in analyzing events and applies expert technical knowledge followin
Position Purpose: Utilizes business expertise to facilitate, lead and drive complex large scale work efforts across domains and/or large scale cross functional initiatives with matrixed team support. Analyzes and measures the effectiveness of existing business processes and develop sustainable, scalable and quantifiabl
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 the California Market. Open to applicant
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 the Ambetter / Marketplace brand by revi
Position Purpose: Direct and oversee regulatory compliance operations to ensure fully compliance with all applicable laws and regulations for assigned products/services. Key Details: The role is fully remote. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the fut
Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of member's care in accordance with ABA guidelines. Key Details: This is a fully remote role. Preference will
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 position supports New Hampshire Heal
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 timely, appropriate c
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. - Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. - Performs medical re
Position Purpose: Uses advanced expertise and knowledge to lead the development and operationalization of data pipelines to make data available for consumption (reports and advanced analytics), including data ingestion, data transformation, data validation / quality, data pipeline optimization, and orchestration. Works
Position Purpose: Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health and substance use. Key Details: This is a remote position. Candidate m
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/caregivers on services an
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. - Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. - Performs medical re
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/caregivers on services an
Position Purpose: Assesses, plans, and 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
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/caregivers on services an
Position Purpose: Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting , as well as designing and programming complex, new processes/reports. Acts as subject matter expert for department or business unit on business systems/app
Position Purpose: Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. 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 fut
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/caregivers on services an
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 the necessity and se
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: Must reside in the state of Georgia. Med/
Position Purpose: Assist in the planning, implementation and evaluation of the state-wide marketing & communication program while promoting a favorable public image of the company and each of its product lines. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship no
Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures. - Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s polic
Position Purpose: Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibil
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. Provides education for HEDIS measures, a
Position Purpose: With the Corporate IT Finance Team, you will compile and analyze financial information for the company. Partner closely with business and finance leadership to deliver insightful analysis, develop measures to track, trend and forecast related impacts of organizational strategic initiatives. Key Detail
****NOTE: This is a work-from-home, remote role with occasional travel (up to 10%) to our various Ohio offices for essential business meetings. This position supports Long Term Care (LTC) Care Coordination through activities such as member outreach and mailings, appointment scheduling and reminders, prescription coordi
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: Must reside in Georgia. Must have OB expe
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 home-visits and documen
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: Must be authorized to work in the U.S. wi
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 support to matrixed t
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 versions, baselines, constituent compon
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 our members. Engage with providers to ali
Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. 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 spon
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 the necessity and se
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substa
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substa
Position Location: Remote in FL 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. - Oversee the coordinat
Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned 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 sponsorship are not available for this opport
Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. 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 spon
Position Purpose: Supervises the care coordination team that serves long-term care members to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management issues related to members or providers. Key Details: This is a remote position; however, the associate will mainta
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 their families/caregiver
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 the necessity and se
Position Purpose: The main focus of the role is to support the cash related accounting processes for Medicaid Health Plans along with maintaining accurate financial records, prepare monthly financial statements and participate in special projects. Key Details: Applicants for this role have the flexibility to work remot
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, working as part of a cross-functional eff
Position Purpose: Provides comprehensive support to Fidelis and Wellcare members by addressing inquiries, conducting outreach, and assisting with enrollment in various health plans, including Medicaid, Medicare, and other Fidelis Care products. This role requires in-depth product knowledge, consultative selling, and th
Position Purpose: Provides comprehensive support to Fidelis and Wellcare members by addressing inquiries, conducting outreach, and assisting with enrollment in various health plans, including Medicaid, Medicare, and other Fidelis Care products. This role requires in-depth product knowledge, consultative selling, and th
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 and solutions, and consultative account
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. Provides education for HEDIS measures, a
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 and solutions, and consultative account
Position Purpose: Develops and implements effective business solutions through research, audit, and analysis of data and/or business processes. Audits and validates routine pre and post payment claims to determine correct adjudication as well as compliance with corporate policies and procedures, and other applicable re
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/caregivers on services an
Position Purpose: This role serves as a trusted advisor to leaders and employees across the enterprise, providing guidance and support on a wide range of workplace matters while helping ensure fair, consistent, and compliant employment practices. The People Relations (PR) Partner manages employee relations cases from i
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 the necessity and se
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 Delegation partners and internal Departments.
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 members. Engage with providers to align o
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, member-centered care by identifying gap
Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans. 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
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. Provides education for HEDIS measures, a
Position Purpose: Responsible for clinical file assessments. Identifies monthly insights for improvement and participates in Interrater Reliability meetings. Aids in efforts to continuously develop review tools to ensure validity of criteria, and appropriately captures evidence of expected clinical performance within c