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Claims Liaison I

Claims Liaison I

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description: Position Purpose\: Serve as a liaison between the plan, claims, providers and various departments to effectively identify and resolve claims issuesAudit check run and send claims to......

Long Term Care Coordinator I

Long Term Care Coordinator I

Ottumwa, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Utilization Manager (Behavioral Health)

Utilization Manager (Behavioral Health)

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings,......

Referral Specialist II

Referral Specialist II

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations and act as trainer and......

Program Specialist II

Program Specialist II

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\:¬ Identify special needs members through the completion of health screens and other resources Work with community outreach/member advocates to coordinate member care......

Behavioral Case Mgr

Behavioral Case Mgr

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify......

Clinical Appeals Coordinator

Clinical Appeals Coordinator

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Act as the liaison for all statewide appeals, fair hearings, review organizations, and other external type appeals. Responsible for ensuring that all appeal letters......

Long Term Care Coordinator I

Long Term Care Coordinator I

Creston, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Long Term Care Coordinator II

Long Term Care Coordinator II

Mason City, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Pharmacy Coordinator

Pharmacy Coordinator

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan√ʬ€¬™s pharmacy......

Program Coordinator II

Program Coordinator II

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform duties to assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.√‚¬∑¬ Initiate authorization......

Referral Specialist I

Referral Specialist I

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations. Initiate authorization......

Long Term Care Coordinator II

Long Term Care Coordinator II

Creston, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Program Coordinator I

Program Coordinator I

Des Moines, IA
Centene Corporation
Medical & Healthcare  NEW!
Description:Position Purpose\: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.√‚¬∑¬ Initiate authorization requests for output......

HEDIS Coordinator

HEDIS Coordinator

Des Moines, IA
Centene Corporation
Professional Services  NEW!
Description:Position Purpose\: Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement......

EPSDT Coordinator

EPSDT Coordinator

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Plan, organize, and coordinate all aspects of the EPSDT (Early Preventative Screening Diagnostic Testing) program. Ensure compliance of EPSDT with all state and......

Long Term Care Coordinator II

Long Term Care Coordinator II

Ottumwa, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Long Term Care Coordinator I

Long Term Care Coordinator I

Mason City, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Quality Improvement Abstractor

Quality Improvement Abstractor

Des Moines, IA
Centene Corporation
Professional Services  NEW!
Description:Position Purpose\: Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and/or any other custom measurements. Assess vendor-delegated......

Long Term Care Coordinator II

Long Term Care Coordinator II

Atlantic, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Concurrent Review Nurse I

Concurrent Review Nurse I

Des Moines, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:√‚¬∑¬ Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or......

Manager, Accreditation

Manager, Accreditation

Des Moines, IA
Centene Corporation
Professional Services  NEW!
Description:Position Purpose\: Ensure compliance with accreditation requirements and conduct routine readiness assessment and evaluation of policies and procedures, processes and recordsOversee the......

Long Term Care Coordinator I

Long Term Care Coordinator I

Atlantic, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Long Term Care Coordinator I

Long Term Care Coordinator I

Spencer, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Long Term Care Coordinator II

Long Term Care Coordinator II

Spencer, IA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation,......

Care Manager I (Social Work)

Care Manager I (Social Work)

Tacoma, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Care Manager I (Social Work)

Care Manager I (Social Work)

Yakima, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Care Manager I - Social Work

Care Manager I - Social Work

Spokane, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Care Manager I (Social Work)

Care Manager I (Social Work)

Yakima, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Case Manager I

Case Manager I

Yakima, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Respiratory Therapist In-Home Patient Educator/Field Health Coach

Respiratory Therapist In-Home Patient Educator/Field Health Coach

Renton, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform in-home respiratory assessments to patients and educate them on the physician√ʬ€¬™s treatment plan and medication regimen. Plan, perform......

Care Manager II

Care Manager II

Vancouver, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Care Manager II (RN)

Care Manager II (RN)

Seattle, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: The Care Manager II is responsible for providing care management services to beneficiaries with planned admissions to acute care hospitals, or to those transitioning......

Manager, Case Management

Manager, Case Management

Yakima, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to......

Concurrent Review Nurse I

Concurrent Review Nurse I

Vancouver, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or......

Care Manager I (RN)

Care Manager I (RN)

Tacoma, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Care Manager II

Care Manager II

Vancouver, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Care Manager II RN

Care Manager II RN

Seattle, WA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

Case/Care Manager I (Non CA)

Case/Care Manager I (Non CA)

Rancho Cordova, CA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Provides case/care management services to a specific clientele. Screens cases for possible case management services according to predetermined criteria.......

Nurse Care Manager II

Nurse Care Manager II

Sacramento, CA
Centene Corporation
Retail & Wholesale  NEW!
Description:Position Purpose\: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to......

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