You could be the one who changes 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.
Position Purpose: Leads and directs the care management team and the care management of members to develop and assess high quality, cost-effective healthcare outcomes. Leads and develops strategies and objectives within care management to improve member and/or provider experience. Must reside or be willing to relocate to Washington state.
- Provides oversight and leadership to the development, implementation, monitoring, and ongoing improvement of the care management process
- Provides senior leadership team a vision and direction for the department to help achieve functional goals, and communicates goals to care management team
- Leads and enforces care management policies and procedures within the care management team to ensure compliance with regulatory requirements for federal, state, and National Committee for Quality Assurance (NCQA) standards, as required
- Attends conferences and stays up to date on latest trends and best practices in Payer Care Management and related fields
- Provides subject matter expert guidance to senior leadership and care management team on the latest care management policies, procedures, and standards
- Reviews reports to ensure adherence to department budget and identify trends to effectively forecast
- Implements care management strategies that align to organizational objectives
- Engages with onboarding, hiring, and training new care management team members to support future growth and strategy
- Leads and manages process improvements for the care management team to achieve quality and cost-effective healthcare results and working with senior leadership, as required
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires a Bachelor's degree and 10+ years of related experience, including prior management experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
License/Certification:- Current state's Registered Nurse (RN) license preferred
Pay Range: $140,300.00 - $259,100.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
