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Clinical Appeals Coordinator

Clinical Appeals Coordinator

Albuquerque, NM
Centene Corporation
Medical & Healthcare
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 generated......

Clinical Appeals Coordinator

Clinical Appeals Coordinator

Albuquerque, NM
Centene Corporation
Medical & Healthcare
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......

Manager, Case Management

Manager, Case Management

Yakima, WA
Centene Corporation
Medical & Healthcare
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......

Clinical Appeals Coordinator

Clinical Appeals Coordinator

Austin, TX
Centene Corporation
Medical & Healthcare
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......

Payroll Representative

Payroll Representative

Saint Louis, MO
Centene Corporation
Accounting
Position Purpose: Input and review the payroll function to ensure timely payment and reporting of earnings for company employees.Data enter payroll information including timesheets.Review time......

Reconciliation Coordinator I

Reconciliation Coordinator I

Austin, TX
Centene Corporation
Insurance
Position Purpose: Responsible for the reconciliation of the error authorization report to claims. Develop and monitor authorization errors trending and patterns by type of error. Provide trending......

Program Specialist II - Social Work

Program Specialist II - Social Work

Orlando, FL
Centene Corporation
Medical & Healthcare
Position Purpose:Identify special needs members through the completion of health screens and other resourcesWork with community outreach/member advocates to coordinate member careEducate providers......

Clinical Formulary Pharmacist - Clinical Benefits CA-Fresno

Clinical Formulary Pharmacist - Clinical Benefits CA-Fresno

Fresno, CA
Centene Corporation
Medical & Healthcare
Position Purpose: Define and develop standard and custom formularies for all lines of business including Commercial, Medicaid, Medicare Part D and the Health Information MarketplaceDevelop drug......

Senior Provider Relations Representative

Senior Provider Relations Representative

San Rafael, CA
Centene Corporation
Medical & Healthcare
Position Purpose: Under direction, the Senior Provider Relations Representative maintains working relationships with provider organizations as assigned. This position is responsible for assuring......

Strategy %26 Planning Manager (CA Market)

Strategy %26 Planning Manager (CA Market)

Woodland Hills, CA
Centene Corporation
Advertising & Marketing Jobs
Position Purpose:Manages and maintains agendas, minutes, calendar, materials, etc. for staff meetings and other requested meetingsWorks with key areas of the company (e.g., lines of business and......

Ambetter Health %26 Benefits Specialist

Ambetter Health %26 Benefits Specialist

Austin, TX
Centene Corporation
Medical & Healthcare
Position Purpose:Identify members through the completion of health screens and other resourcesWork with community outreach/member advocates to coordinate member careEducate providers and community......

Manager, Provider Relations

Manager, Provider Relations

Tempe, AZ
Centene Corporation
Medical & Healthcare
Position Purpose: Responsible for maintaining existing and developing new provider relations, and assisting with contracting activitiesManage the staff in contracting area including work flow,......

Business Development Analyst

Business Development Analyst

Saint Louis, MO
Centene Corporation
Advertising & Marketing Jobs
Position Purpose: Focus on mergers and acquisition activities, including financial modeling and valuation analysis, tracking of current and prospective targets, competitive analysis and industry......

Cyber Security Analyst I

Cyber Security Analyst I

Rancho Cordova, CA
Centene Corporation
Information Technology (IT)
Position Purpose: Under general supervision, this role provides support the Cyber Security team with protecting confidentiality and integrity of the organizations information assets. Responsible......

Membership Accounting Representative I (Operations)

Membership Accounting Representative I (Operations)

Woodland Hills, CA
Centene Corporation
Accounting
Position Purpose: Under direct supervision, the Membership Accounting Representative I allocates payments, and reconciles and audits assigned individual and employer group accounts. Reviews work......

Senior Business System Analyst (IT Problem Management)

Senior Business System Analyst (IT Problem Management)

Chesterfield, MO
Centene Corporation
Information Technology (IT)
Position Purpose: Design, build, test and maintain enablers of business processes, including technology and process solutions with a focus on medium to high complexity, multiple large application......

Operations Intern - Summer 2019

Operations Intern - Summer 2019

Columbia, SC
Centene Corporation
Information Technology (IT)
* Work closely with leadership to gain exposure to the company and participate in a variety of projects and tasks* Assist with pilot projects and case studies as needed* Support efforts related to......

Program Specialist I - Social Work

Program Specialist I - Social Work

Topeka, KS
Centene Corporation
Medical & Healthcare
Position Purpose:Identify special needs members through the completion of health screens and other resourcesWork with community outreach/member advocates to coordinate member careEducate providers......

Trainer II- MarketPlace

Trainer II- MarketPlace

Saint Louis, MO
Centene Corporation
Medical & Healthcare
Position Purpose: Responsible for developing and conducting a variety of training programs and/or auditing tools.Conduct training needs analyses to determine specific training needs for department......

Manager, Data Analysis

Manager, Data Analysis

Saint Louis, MO
Centene Corporation
Information Technology (IT)
Position Purpose: Support analytic data needs for assigned business unit. Handle complex data requests and acts as a "go to" person for other Data Analysts.Identify and prioritize......

Behavioral Care Coordinator

Behavioral Care Coordinator

Oxford, MS
Centene Corporation
Medical & Healthcare
Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Provide outreach and preventative care to members seeking services in the least restrictive......

Supervisor, Quality Assurance (Marketplace)

Supervisor, Quality Assurance (Marketplace)

Rancho Cordova, CA
Centene Corporation
Advertising & Marketing Jobs
Position Purpose:* Design, develop, and oversee quality assurance and monitoring programs to develop sustainable, repeatable, and quantifiable process improvementsAssess audits conducted by......

Grievance %26 Appeals Nurse (CA)

Grievance %26 Appeals Nurse (CA)

Woodland Hills, CA
Centene Corporation
Medical & Healthcare
Position Purpose:Review clinical data to determine claim payment based on company policies and National Committee for Quality Assurance (NCQA) guidelines, including overturning denied claims,......

Manager, Public Relations

Manager, Public Relations

Woodland Hills, CA
Centene Corporation
Advertising & Marketing Jobs
Position Purpose: Manage and execute media and public relations campaigns to engage and educate external audiences on the company's mission, goals, and progress. Responsible for overseeing......

Trainer II

Trainer II

Bedford, NH
Centene Corporation
Medical & Healthcare
Position Purpose: Responsible for developing and conducting a variety of training programs and/or auditing tools.Conduct training needs analyses to determine specific training needs for department......

Data Analyst II

Data Analyst II

Saint Louis, MO
Centene Corporation
Information Technology (IT)
Position Purpose:Analyze health management programs including: data collection, validation and outcome measurement. May include:o Financial, pharmacy, claims, provider, and member datao IRS, CMS,......

Graduate Business Development Intern - Summer 2019

Graduate Business Development Intern - Summer 2019

Saint Louis, MO
Centene Corporation
Advertising & Marketing Jobs
Position Purpose:* Assist Hiring Manager with various Business Development and Implementation initiatives for both long and short term projects* Design assets for various business units as needed......

Director, Compliance

Director, Compliance

Smyrna, GA
Centene Corporation
Accounting
Position Purpose:Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory......

Sales Representative (Medicare) Jacksonville FL

Sales Representative (Medicare) Jacksonville FL

Jacksonville, FL
Centene Corporation
Sales
Position Purpose: Provide sales coverage and develop bestpossible market penetration for all products to present to prospective membersin assigned territory in accordance with company policies and......

Clinical Trainer

Clinical Trainer

Austin, TX
Centene Corporation
Human Resources (HR)
Position Purpose: Responsible for developing and conducting a variety of training programs and auditing tools for clinical department staff on the company's clinical philosophy and evidence......

Quality Specialist II

Quality Specialist II

Pittsburgh, PA
Centene Corporation
Customer Service & Call Center
Position Purpose: Maintain a comprehensive working knowledge of policies, procedures and services in order to ensure the appropriate level of customer service is delivered and/or accuracy and......

Director, Provider Payment Innovation, Provider Network Management

Director, Provider Payment Innovation, Provider Network Management

Saint Louis, MO
Centene Corporation
Professional Services
Position Purpose:Leads provider innovation, provider initiatives and network strategy, including network provider pricing and cost optimization, trend analysis and provider network improvement......

Vice President, Operations

Vice President, Operations

Chesterfield, MO
Centene Corporation
Professional Services
Position Purpose: Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and......

Care Manager I (RN) (Austin or San Antonio, TX)

Care Manager I (RN) (Austin or San Antonio, TX)

Austin, TX
Centene Corporation
Medical & Healthcare
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......

Prior Authorization Nurse II (RN)

Prior Authorization Nurse II (RN)

Saint Louis, MO
Centene Corporation
Medical & Healthcare
Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization......

Director, Reporting %26 Business Analytics

Director, Reporting %26 Business Analytics

Albuquerque, NM
Centene Corporation
Information Technology (IT)
Position Purpose: Oversee all of the reporting and data analytics for the department and/or customer, including operational scorecards other reporting and data requirements as defined by......

Care Coordinator II (New Mexico)

Care Coordinator II (New Mexico)

Carlsbad, NM
Centene Corporation
Medical & Healthcare
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 Coordinator I (Roswell)

Care Coordinator I (Roswell)

Roswell, NM
Centene Corporation
Medical & Healthcare
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 Coordinator II

Care Coordinator II

Santa Fe, NM
Centene Corporation
Medical & Healthcare
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 Coordinator I

Care Coordinator I

Gallup, NM
Centene Corporation
Medical & Healthcare
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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