Browse current Centene Corporation openings that JobDrop found directly from the company's careers source.
***NOTE: We are seeking talented Account Executives in the Raleigh, North Carolina or Richmond, Virginia areas. *** Position Purpose: Represent the company to all prospective and existing clients. Monitor client satisfaction and recommend changes to enhance satisfaction. - Drive specialty pharmacy growth by building st
The Manager, Care Coordination will lead community health workers, social workers, and resource coordinators across Georgia. Candidates must reside in Georgia and have strong Medicaid experience. The schedule is Monday through Friday, approximately 8:00 a.m. to 5:30 p.m., with flexibility to support staff working until
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. Key Details: Centene is seeking a remote Utilization Review Clinician – Behavioral He
Position Purpose: Leads projects to develop, monitor, maintain, improve and automate the enterprise security processes, reduce the overall enterprise security risk and creates reports that will impact decisions made at both the executive and Board levels. Key Details: Must be authorized to work in the U.S. without the
Position Purpose: Develop, monitor, and maintain the enterprise security program. Assist in the compliance of enterprise security initiatives. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not avail
Position Purpose: Manage the Security Compliance team to provide enterprise security oversight. Set strategic direction of the team to improve enterprise security programs based on compliance and risk drivers. Manage compliance of enterprise security initiatives. Key Details: Must be authorized to work in the U.S. with
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. Key Details: This fully remote role supports the Kentucky Market by completing inpati
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. Key Details: This fully remote role supports the Kentucky Market by completing outpat
Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Key Details: This position is remote/work from home. Prefer applicants who reside in the state of Illinois. Role supports Meridian Medicaid and Youth Care mem
Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, a
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT **Applicants for this role have the flexibilit
Position Purpose: Lead sales operations functions, including sales and experience reporting and data management, sales systems oversight and management, broker support, broker and agent commissions and incentive programs, and alignment with finance on sales projections and forecasting. Act as the primary senior leader
Position Purpose: Support the data management and quality improvement initiatives for assigned functional areas Key Details: Must reside in the state of Iowa or Kansas. Quality and Provider Performance experience highly preferred. - Assist with the development and coordination of all core health services data reports -
The Senior Care Manager (RN) supports high-risk members through assessments, individualized care planning, outreach, and complex caseload management. The role also assists with case setup and backup training. Candidates must reside in North Carolina, hold an NC RN license, and have care management experience. The sched
The Lead Care Manager will support the pediatric and maternity care management population, with responsibilities that include managing complex cases, setting up cases, supporting audits, and assisting with the training and onboarding of new team members. This is a remote position; however, candidates must reside in Nor
Position Purpose: Provides in-depth technical and business knowledge with regards to SAS. Adds advanced technical support to one or more business areas through developed and ad hoc analysis/reporting within SAS, as well as designing and programming complex, new processes/reports with SAS. Acts as SAS subject matter exp
Position Purpose: Supports Enterprise Privacy & Security Risk Management (EPSRM) and other teams across Centene by translating complex regulatory, legislative, and contractual requirements into actionable, risk-informed analysis and advisory-ready outputs, among other duties. Serves as a critical execution layer within
Position Purpose: Supports Enterprise Privacy & Security Risk Management (EPSRM) and other teams across Centene by translating complex regulatory, legislative, and contractual requirements into actionable, risk-informed analysis and advisory-ready outputs, among other duties. Serves as a critical execution layer within
Position Purpose: Supports Enterprise Privacy & Security Risk Management (EPSRM) and other teams across Centene by translating complex regulatory, legislative, and contractual requirements into actionable, risk-informed analysis and advisory-ready outputs, among other duties. Serves as a critical execution layer within
Position Purpose: Supports Enterprise Privacy & Security Risk Management (EPSRM) and other teams across Centene by translating complex regulatory, legislative, and contractual requirements into actionable, risk-informed analysis and advisory-ready outputs, among other duties. Serves as a critical execution layer within
Position Purpose: Supports Enterprise Privacy & Security Risk Management (EPSRM) and other teams across Centene by translating complex regulatory, legislative, and contractual requirements into actionable, risk-informed analysis and advisory-ready outputs, among other duties. Serves as a critical execution layer within
Position Purpose: Direct, strategize, negotiate and handle activities of the marketing and sales functions. Support the company’s strategic plan and establish the strategic vision, objectives, and policies and procedures. Develop programs that effectively describe, promote and sell the organization’s Medicaid, Medicare
Position Purpose: Direct, strategize, negotiate and handle activities of the marketing and sales functions. Support the company’s strategic plan and establish the strategic vision, objectives, and policies and procedures. Develop programs that effectively describe, promote and sell the organization’s Medicaid, Medicare
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Key Details: Must be a Board Certified Psychiatrist and licensed in either California or Oregon. Highly preferred the candidate lives in the Pacific
Position Purpose: Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports the care team to identify member community
Position Purpose: Develop written responses to complex, high-scoring Medicaid Request for Proposal (RFP) section supporting the company's growth and expansion goals. Key Details: Occasional evening and weekend work may be required during peak RFP and re-procurement periods. Clinical healthcare experience and strong Med
Position Purpose: Manage strategic vendor partnerships and enterprise initiatives, including vendor evaluation, contracting, implementation, governance, and performance oversight to support clinical, operational, and financial objectives. Key Details: This position is remote within the United States with 10% travel req
Position Purpose: Lead the development and execution of business development strategies that expand the company's market presence and drive growth of Individual Coverage Health Reimbursement Arrangements (ICHRAs). Build and strengthen relationships with brokers, employers, and key stakeholders; identify and advance new
Position Purpose: Manage and oversee the coordination of regulatory audits, examinations, and oversight activities for a regional portfolio of Medicaid health plans across the West Region. Provide leadership and direction to team members responsible for day-to-day audit execution while ensuring consistent application o
Position Purpose: Responsible for connecting with plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS, CAHPS, HOS, Part D and Administrative Operations reports and gap lists with providers. Use existing resources to collaborate with provider offices and internal partners on
Position Purpose: Leads the integrity and governance of Centene's and/or its vendors corporate ethics and compliance program, and ongoing oversight and analysis of regulatory compliance practices. Key Details: Applicants for this job have the flexibility to work remote from home anywhere in the Continental United State
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 reside in the state of Florida. ABA trea
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: The Supervisor Operations p
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 a personalized care plan / service plan
Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records, provider information, and other relevant evidence to identify potential misconduct and support case resolution. Document investigative activities, prepare reports and referrals, collaborate with
Position Purpose: Serves as a strategic business partner overseeing both vendor relationship management and financial performance for assigned business units or delegated entities. Integrates operational oversight with fiscal accountability, ensuring budget discipline, accuracy in financial reporting, and optimal vendo
Position Purpose: Drive market-leading business acquisition growth and retention through national operating scale and consumer-insight driven marketing activations for our ICHRA plans. Key Details: Centene is advancing Individual Coverage Health Reimbursement Arrangement (ICHRA) adoption as a market-based alternative t
Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records, provider information, and other relevant evidence to identify potential misconduct and support case resolution. Document investigative activities, prepare reports and referrals, collaborate with
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 a personalized care plan / service plan
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 a personalized care plan / service plan
Position Purpose: Plan and drive execution of Medical Management utilization programs, processes, and initiatives to ensure achievement of health benefit ratio targets, and appropriate reductions in utilization related expenses. Provide vision and strategic leadership for the development and implementation of compliant
Position Purpose: Directs the utilization management team to ensure the appropriate application of policy procedures and processes to help support best member outcomes. Oversees and manages Utilization Operations specific to the daily operations of Utilization Management including timeliness, quality and performance ou
Position Purpose: Responsible for connecting with plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS, CAHPS, HOS, Part D and Administrative Operations reports and gap lists with providers. Use existing resources to collaborate with provider offices and internal partners on
Position Purpose: Research, develop, design, analyze, evaluate, and administer corporate benefit plans and programs in a large, multi-state employer environment. Key Details: - Candidates must reside in CST or EST to be considered for the position. - Large employer experience is imperative to potential success in the r
Position Purpose: Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. Key Details: This is a remote position, but applicants must reside in North Carolina. Candidates must hold one of the follo
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: This is a remote position, but applicants mus
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. Key Details: This position is Tuesday-Saturday or Wednesday - Sunday 8am to 5pm with
Position Purpose: 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 healthcare outcomes. Evaluates member service needs and develops or contributes to development o
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 telephonically or through home-visits and documen
This is a remote position and can be located anywhere in the US. Position Purpose: Develop innovative procurement solutions at a project/category/organizational level and provide guidance to category team for sourcing event level strategies. Engage senior leadership team to drive buy-in and adoption into the category s
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Key Details: This remote Care Manager (RN) position re
Position Purpose: Responsible for driving the product performance function for assigned products, across multiple lines of business. Oversee the review of product performance, the analysis of performance of products, the coordination of product improvement initiatives, and the preparation of executive leadership for re
Position Purpose: Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical records, provider information, and other relevant evidence to identify potential misconduct and support case resolution. Document investigative activities, prepare reports and referrals, collaborate with
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: This is a remote position, but applicants mus
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 telephonically or through home-visits and documen
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 a personalized care plan / service plan
Position Purpose: Responsible for leading the integration, modernization, and efficient operation of Centene's enterprise telephony and contact center platforms. Involves close collaboration with business process owners, external technology vendors, and Business Technology Systems professionals to align telephony and c
Position Purpose: Provides strategic and operational leadership for enterprise interoperability capabilities across the enterprise. Responsible for enabling healthcare data to move securely and seamlessly between systems, organizations, stakeholders including members, providers, payers and business partners. Leads the
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 a personalized care plan / service plan
Position Purpose: Leads the strategy, development, and execution of product, customer experience, digital and operational capabilities for the ICHRA business. Responsible for translating customer and market insights into scalable solutions, driving digital innovation, operational excellence, and business growth. Partne