Centene
40 open jobs
Finance Analyst III - Managed Care
Position Purpose: With the Corporate Quality and Affordability Initiatives Finance team, you will analyze complex financial information and translate data into meaningful insights that support business decisions. Independently lead financial projects and initiatives, partnering
Commercial Product Manager
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,
Asset and Configuration Analyst II
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,
LTSS Service Care Manager - Behavioral Health
Position Purpose: **For use by Arizona, Superior, and Sunflower only.** Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective
Applyto LTSS Service Care Manager - Behavioral Health at Centene seen live 1 day ago posted 2 days agoRN, Senior LTSS Service Care Manager
Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops
Program Manager IV
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 helping ensure appropriate coordination, visibility, and management of key
Accountant I
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
Utilization Review Clinician - ABA
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: Must
Sales Representative (Medicare)
Position Purpose: Provide sales coverage and develop best possible market penetration for all products to present and prospective accounts in his/her assigned territory in accordance with company's policies and programs. Provide greater access to health insurance, by providing
Senior LTSS Service Care Manager (RN)
Position Purpose: **For use by Arizona, Superior, and Sunflower only.** Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health
Clinical Investigator Behavioral Health
Position Purpose: Conduct comprehensive reviews of medical records and documents supporting claims for providers, suppliers, and pharmacies to include but not limited to physicians, inpatient, outpatient, ancillary, behavioral health care, laboratory, etc. Provides investigative
Performance Monitor Specialist, Clinic
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
Care Coordinator II
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
Care Manager
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
Program Manager III
Position Purpose: The Program Manager leads and supports strategic initiatives and ongoing operational priorities across Member and Provider Services. This role coordinates cross-functional stakeholders, manages risks and dependencies, and drives timely execution while
Team Lead, Care Management Support Coordinator
Position Purpose: Works with care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member
Applyto Team Lead, Care Management Support Coordinator at Centene seen live 1 day ago posted 2 days agoCare Management Support Coordinator II
Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with
Senior LTSS Service Care Manager (RN)
Position Purpose: **For use by Arizona, Superior, and Sunflower only.** Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health
Quality Care Member Advocate
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
Clinical Review Nurse - Concurrent Review
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
Lead Payment Integrity Systems Specialist
Position Purpose: The Lead Payment Integrity Systems Specialist is the senior individual contributor and enterprise-level subject-matter expert for Payment Integrity systems, platform governance, analytics, financial reporting, and operational visibility. The role sets technical
Payment Integrity Systems Specialist II
Position Purpose: The Payment Integrity Systems Specialist II performs moderately complex Payment Integrity systems, data, reporting, and workflow analysis. The role supports platform enhancements, defect remediation, reporting routines, UAT/release readiness, financial and
Clinical Review Nurse - Concurrent Review
Conduct inpatient concurrent reviews to assess medical necessity using InterQual criteria, corporate and state policies, and available review tools. Support New Hampshire Medicaid through the East Region Shared Services team. Work from 8:00 a.m. to 5:00 p.m. Eastern Time, with
Care Management Support Coordinator IV - Team Lead
Position Purpose: Leads the care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues for care plan-related
Applyto Care Management Support Coordinator IV - Team Lead at Centene seen live 1 day ago posted 2 days agoSenior Consumer Experience Analyst
Position Purpose: The Consumer Experience Analyst Sr. is responsible for utilizing a variety of analytical techniques, current system applications, consumer research data, call center and other ad hoc and system generated reports and other data sources within the organization to
LTSS Service Care Coordinator
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
Quality Improvement Coordinator II
Position Purpose: Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communicate with
Care Manager
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
Medical Economics Analyst Intern (Undergraduate - Summer 2027)
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
Applyto Medical Economics Analyst Intern (Undergraduate - Summer 2027) at Centene seen live 1 day ago posted 2 days agoClinical Review Nurse - Concurrent Review
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
LTSS Service Care Manager - Behavioral Health
Position Purpose: **For use by Arizona, Superior, and Sunflower only.** Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective
Applyto LTSS Service Care Manager - Behavioral Health at Centene seen live 1 day ago posted 2 days agoProgram Manager III - SIU Intelligence & Innovation
Position Purpose: This role is critical to advancing SIU’s Intelligence & Innovation strategy through the design, development, and execution of proactive fraud detection, analytics, and investigative intelligence programs. The position serves as a key driver in identifying
Applyto Program Manager III - SIU Intelligence & Innovation at Centene seen live 1 day ago posted 2 days agoProject Manager IV - Business Operations
Position Purpose: As a member of the Corporate Business Operations team, this role independently leads complex programs comprised of multiple projects and workstreams. The position is responsible for proactively identifying and mitigating risks, managing interdependencies, and
VP, Network Development & Contracting - Sunshine State Health Plan
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
Applyto VP, Network Development & Contracting - Sunshine State Health Plan at Centene seen live 1 day ago posted 2 days agoSupervisor, Care Management - LTSS
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
Utilization Review Clinician - Behavioral Health
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. Evaluates member’s treatment for mental
Applyto Utilization Review Clinician - Behavioral Health at Centene seen live 1 day ago posted 2 days agoLTSS Service Care Coordinator
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
Medical Economics Intern (Undergraduate - Summer 2027)
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
Applyto Medical Economics Intern (Undergraduate - Summer 2027) at Centene seen live 1 day ago posted 2 days agoClinical Review Nurse - Concurrent Review
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
Provider Engagement Account Manager
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