About the role
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Candidate must reside in Arizona. Remote position with 25% travel statewide.
Education and Experience: Bachelor's degree in applicable field of study and 4 years of experience in Behavioral Health or Quality Improvement. Minimum of 2 years clinical supervisory experience.
- Manage all quality of care requirements to ensure the program meets the standards defined by the State, URAC and the annual Quality Management Plan
- Train, supervise, and monitor Quality of Care (QOC) Specialists to ensure accurate and timely processing of QOC data and subsequent reporting requirements
- Ensure clinical investigations and reporting processes are followed in accordance with the State requirements
- Analyze, track and trend results and develop accurate, timely quality indicator reports for management
- Recommend, develop, and implement quality improvement plans with management
- Train providers and staff in methodologies and tools of continuous quality improvement
- Prepare for, and participate in, meetings with various committees, State agencies, providers, and stakeholders. Provide clinical support to medical record audit and quality improvement processes
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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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
Aplyr's read
Centene is a key player in government-sponsored healthcare, focusing on under-insured populations. It offers diverse roles across compliance, analytics, and medical management.
What's promising
- •Centene's focus on government-sponsored programs ensures a steady demand for its services.
- •The company offers diverse roles, from analytics to medical leadership, catering to various professional backgrounds.
- •Centene's commitment to under-insured populations aligns with growing healthcare equity trends.
What to watch
- •Regulatory changes in healthcare policies can impact Centene's business model significantly.
- •The complexity of government contracts may lead to compliance challenges.
- •High competition in the healthcare sector could pressure Centene's market share.
Why Centene
- •Centene specializes in serving under-insured and uninsured individuals through government programs.
- •The company's multinational presence allows it to leverage diverse healthcare systems.
- •Centene's comprehensive service portfolio addresses a wide range of healthcare needs.
Aplyr’s read is generated by AI from public sources. Was it useful?
About Centene
Centene Corporation is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government-sponsored healthcare programs, focusing on under-insured and uninsured individuals.
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