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Contract Negotiator II 1180634 Position Purpose Recruit physician hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate health plan and State guidelines Ensure..
Claims Analyst I 1181473 Position Purpose Review claims to ensure compliance with established claim entry and claim payment policies and procedures Review and release pended claims Process member receipts Assist..
Service Coordinator II - LVN Field 1181112 Position Purpose Determine needs and eligibility of members for various services through field-based collaboration with medical behavioral and social support staff Conduct screening..
Special Investigation Unit Investigator Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure..
Vice President, Clinical Operations Centene Corporation Saint Louis MO Apply Now Email this job Save NEW Full Time Job Description Position Purpose: Oversee and direct all clinical operations, including care..
Senior Application Software Engineer (ETL) Position Purpose: Design, build, test and maintain scalable and stable off the shelf application or custom built technology solutions to meet business needs. Act as..
Senior Behavioral Health Clinical Care Manager','1181610','!*!Position Purpose: Handle inbound and outbound member and provider calls on a clinical phone queue. Ensure members receive behavioral health services appropriate to clinical need...
Manager, Information Technology (Enterprise Projects) Centene Corporation Charlotte NC Apply Now Email this job Save NEW Full Time Job Description Position Purpose: Responsible for the implementation of enterprise wise and..
Supervisor, Customer Service','1179706','!*!Position Purpose: Supervise assigned customer service function at the health plan to meet overall business goals and objectives Ensure the team meets its goals and objectives through effective..
ProfessionalPosition Purpose: Ensure that the Appeals & Grievance department processes all appeals, grievances and complaints in accordance with standards and the corporation’s policies and procedures Serve as a resource to..
Manager, Medical Management Position Purpose: Responsible for managing a complete program of medical management in accordance with the mission, philosophy, and objectives of plan. The position has oversight for the..
Application Software Engineer (Test Automation) USA-Virginia-Arlington Position Purpose: Design, build, test and maintain scalable and stable off the shelf application or custom built technology solutions to meet business needs *..
Manager, HEDIS Operations (Non-Clinical) Position Purpose: Oversee and ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement opportunities. Collaborate with internal and external stakeholders to ensure HEDIS and..
Business Analyst III Centene Corporation Chesterfield MO Apply Now Email this job Save NEW Full Time Job Description Position Purpose: Perform various analysis and interpretation to link business needs and..
Credentialing Specialist I Position Purpose: Assist the plan in credentialing and re credentialing providers. - Credential and re-credential various providers, including physicians, healthcare delivery organizations, or pharmacies, according to applicable..
Intern (Data/Quality Analysis Undergraduate - Summer) Position Purpose: Learn various job functions within the Managed Care industry and explore various career opportunities Apply academic knowledge and learn new skills by..
Senior Financial Systems Analyst (Payroll/Time) Position Purpose: - Identify opportunities for new system functionality for better alignment to business processes - Define and document requirements for configuration and custom developed..
Supervisor, Enrollment & Retention (SHP) Position Purpose: The Supervisor Enrollment & Retention SHP is responsible for attaining Enrollment & Retention objectives for a specific market segment. This position is responsible..
HourlyPosition Purpose: Determine needs and eligibility of members for various services through field-based collaboration with medical, behavioral, and social support staff. Conduct screening and risk assessment interventions per program guidelines...
Pharmacy Technician I','1181389','!*!Position Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients Track and triage coverage determination requests submitted from providers and determine..
Professional Position Purpose: Responsible for analytic data needs of the business unit. Manage multiple, variable tasks and data review processes, as well as mass data entry, maintenance, and update projects...
Senior Application Software Engineer (Process Automation) USA-Missouri-Clayton Position Purpose: Design, build, test and maintain scalable and stable off the shelf application or custom built technology solutions to meet business needs...
Coding Analytics Specialist I (Medical) Position Purpose: - Accept or reject coding recommendations based on provider documentation, administrative policies, regulatory codes, legislative directives, precedent or other guidelines under the guidance..
TRICARE Customer Liaison Position Purpose: Serve as a liaison to Military Treatment Facilities (MTFs) and Enhance Multi Service Markets (eMSMs). Closely monitor delivery of customer service and support and resolving..
Contract Negotiator II','1180634','!*!Position Purpose: Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State guidelines. Ensure that all..
Senior Software Development Engineer in Test','1181406','!*!Casenet, a Centene company, is an engineering driven company that helps improve the lives of millions of people. Our engineers create and deliver world class,..