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.
** This position requires up to 10% travel. Applicants have the flexibility to work remotely from their home anywhere within the state of Kansas the remaining time.**
Position Purpose: Oversees the care management of higher acuity, long-term care members to develop and assess high quality, cost-effective healthcare outcomes. Oversees care management teams' facilitation of member and provider needs through the complete care management cycle.
- Provides guidance and directs long-term care management required documentation to maintain compliance with federal and state regulations and contractual agreements
- Reviews long-term care management policies and procedures as developed within the care management team and presents to senior leadership team
- Oversees and monitors work assignments and caseloads of long-term care management staff based on state requirements, care management staff experience, and member needs
- Manages and tracks achievement against goals and objectives for long-term care management team to achieve cost-effective healthcare results
- Ensure proper coordination and communication of medical service functions with other departmental functions at the business as assigned
- Participates in coordinating large or special project work with other departmental functions
- Identifies process improvements for the long-term care management team to achieve cost- effective healthcare results and presents to senior leadership team
- Reviews and monitors long-term care member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
- Educates and provides resources for long-term care management leaders on key initiatives and member outreach to facilitate on-going communication between care management team, members, and providers
- Provides coaching and guidance to long-term care management team to improve member and provider experience and facilitate delivery of high-quality care
- Manages and coordinates the training of long-term care management team members to ensure adequate training and high-quality care to improve member and provider experience
- Supports in developing the overall strategy for onboarding, hiring, and training new long-term care management team members
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires a Bachelor's degree and 6+ 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: A valid driver's license is required
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act