Manager, Medical Management Operations-- Remote Available Details

Manager, Medical Management Operations-- Remote Available

Centene Corporation - Tampa, FL

Employment Type : Full-Time

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

• Evaluate existing medical management practices for assigned business unit
• Evaluate and resolve inefficiencies; identify and drive process improvement opportunities
• Utilize continuous process improvement techniques to explore approaches to work processes to eliminate waste and ensure resources are allocated to high value activity
• Adopt and modify state specific requirements to ensure compliance with state contractual requirements
• Develop effective and innovative medical management programs, processes, and models keeping abreast of medical trends, industry changes, and state requirements
• Assist with initiatives to bring greater effectiveness and efficiency
• May travel 25-40% of the time

Our Comprehensive Benefits Package:

• Flexible work solutions including remote options, hybrid work schedules and dress flexibility
• Competitive pay
• Paid Time Off including paid holidays
• Health insurance coverage for you and dependents
• 401(k) and stock purchase plans
• Tuition reimbursement and best-in-class training and development
  

Provide support to Medical Management to determine root causes of operational process inefficiencies, process improvement opportunities, and facilitate the creation of action plans for resolution.

Experience/Experience:
Bachelor’s degree in Healthcare Administration, Nursing, Public Health, or related field or equivalent experience. 4+ years of managed care experience. Knowledge of Medicaid, Marketplace, or Medicare related programs preferred.


License/Certification:
RN license preferred.

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.