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26 fresh jobs found
Snowflake Data Engineer II
Remote-TX, United States Centene Corporation logo Centene Corporation
Data provisioning Data reliability Data destruction Data efficiency Data Pipeline Optimization Programming concepts Performance Data Python programming Real-time processing +50
Mid Full Time
USD 62K+
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Staff Vice President, Medicare Quality & Affordability Strategy
Remote-MO, United States Centene Corporation logo Centene Corporation
Clinical vendor management Medicare cost trend analysis Data-driven care models Business process excellence Affordability Process excellence Value-Based Care Models Contract implementation Health management +37
Exec Senior Full Time
USD 182K+
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Utilization Review Clinician - Behavioral Health
Remote-NC, United States Centene Corporation logo Centene Corporation
Medical appropriateness Healthcare Collaboration Treatment plans Clinical Review Utilization Guidelines Regulatory Guidelines Discharge planning Medical management +22
Mid Full Time
USD 52K+
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Psychologist Reviewer
Remote-AZ, United States Centene Corporation logo Centene Corporation
Diagnostic evaluations Psychological testing Clinical Information Behavior Analysis Utilization Psychology Medical necessity Health Services Substance abuse +17
Mid Part Time
USD 86K+
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Provider Engagement Account Manager
Remote-DE, United States Centene Corporation logo Centene Corporation
Consultative account management Demographic information changes Claims Submission Cost and utilization Quality measures Network performance Provider education Utilization Provider engagement +31
Mid Full Time
USD 55K+
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Clinical Appeals Coordinator
Remote-AR, United States Centene Corporation logo Centene Corporation
Appeals coordination Ncqa compliance Ncqa standards Clinical Nursing Clinical Information Utilization NCQA Medical necessity Medical management +17
Mid Full Time
USD 66K+
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Supervisor, Behavioral Health Utilization Management
Remote-AZ, United States Centene Corporation logo Centene Corporation
UM Accreditation Standards Compliance monitoring Utilization Guidelines Medical necessity Clinical Supervision Performance Evaluation Medical management +31
Mid Full Time
USD 73K+
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Supervisor, Membership Data Integrity- User Acceptance Testing
Remote-AR, United States Centene Corporation logo Centene Corporation
HIPAA Transactions QTest Test Plan Creation Requirement analysis Amisys Business process documentation Data reconciliation UAT Microsoft Visio +44
Mid Full Time
USD 68K+
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Remote Medical Director - California
Remote-CA, United States Centene Corporation logo Centene Corporation
Adverse trend evaluation Medical Necessity Review Health financing Medical management programs Provider network development Health care quality Clinical quality improvement Health administration Government programs +44
Exec Senior Full Time
USD 231K+
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Finance Analyst III (Medicaid Revenue, SQL Reporting)
Remote-FL, United States Centene Corporation logo Centene Corporation
Cost and utilization Utilization Financial Forecasting Reconciliation Financial Workflows Claims Medicaid Reports +20
Senior Mid Full Time
USD 68K+
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RN Clinical Review Clinician - Appeals
Remote-CA, United States Centene Corporation logo Centene Corporation
Medical Records Review Interdepartmental Collaboration Case reviews UM Ncqa standards Medicaid regulations Clinical reviews Researching Clinical Review +30
Mid Full Time
USD 52K+
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Utilization Review/Appeals Clinician - ABA
Remote-FL, United States Centene Corporation logo Centene Corporation
ABA services Autism spectrum disorder Medical appropriateness Clinical Standards Applied Behavioral Analysis Behavioral Analysis Healthcare Provider Interaction Applied Behavior Analysis Treatment plans +28
Mid Full Time
USD 52K+
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Quality Improvement Auditor (Clinical)
Remote-NY, United States Centene Corporation logo Centene Corporation
Case reviews Service utilization Medical record audits Clinical recommendations Clinical Audits Performance Data Quality of care Utilization Performance Measurement +25
Mid Full Time
USD 55K+
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Data Analyst III Medical Economics
Remote-FL, United States Centene Corporation logo Centene Corporation
Claims pricing Large databases Microsoft powerbi Data verification Claims payment Microsoft Power BI Clinical outcomes Statistical techniques Utilization +57
Senior Mid Full Time
USD 68K+
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Provider Engagement Administrator II
Remote-NJ, United States Centene Corporation logo Centene Corporation
Claims billing Claims reimbursement Cost and utilization Network performance Provider education Utilization Provider engagement HEDIS Provider Relations +29
Mid Full Time
USD 55K+
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Provider Engagement Account Manager
Remote-WA, United States Centene Corporation logo Centene Corporation
Consultative account management Demographic information changes Cost and utilization Quality measures Network performance Provider education Provider engagement Utilization Provider Relations +30
Mid Full Time
USD 55K+
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Vice President, Children's Health-Care Management
Remote-FL, United States Centene Corporation logo Centene Corporation
Health outcomes initiatives Medicaid compliance Population health strategy Executive leadership Provider contracts UM Quality Initiatives Compliance requirements Clinical programs +57
Exec Senior Full Time
USD 182K+
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Medical Director
Remote-IL, United States Centene Corporation logo Centene Corporation
Health financing Health care quality Medical management programs Substance Use Disorders Provider network development Clinical quality improvement Government programs Clinical Quality Substance use +45
Exec Senior Full Time
USD 221K+
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Pharmacy Coordinator
Remote-IN, United States Centene Corporation logo Centene Corporation
Formulary process Prior authorizations Grievances Employee Training Pharmacy Technician Provider Relations Utilization Health Plan Utilization Review +21
Mid Full Time
USD 64K+
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Senior LTSS Service Care Manager (RN)
Remote-TX, United States Centene Corporation logo Centene Corporation
Long-term care planning Medicaid health assessments Community Resource Coordination Personalized care plan Member advocacy Service authorization Service plan Continuum of care Quality care +39
Senior Full Time
USD 127K+
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Clinical Review Nurse - Concurrent Review
Remote-CA, United States Centene Corporation logo Centene Corporation
Health management systems Health management Medicaid regulations Guidelines Clinical Review Medical necessity Discharge planning Utilization Acute care +20
Mid Full Time
USD 95K+
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Remote Marketplace Medical Director
Remote-MO, United States Centene Corporation logo Centene Corporation
Claims review Medical management programs Provider network development Government programs Health care quality Health financing Clinical quality improvement Personnel management Health administration +39
Exec Mid Full Time
USD 231K+
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Data Analyst III Healthcare Analytics
Remote-MO, United States Centene Corporation logo Centene Corporation
Microsoft powerbi Large databases Claims pricing Clinical outcomes Data verification Claims payment Utilization Healthcare Analytics Microsoft Power BI +52
Senior Mid Full Time
USD 68K+
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Medical Director
Remote-OH, United States Centene Corporation logo Centene Corporation
Substance Use Disorders Medical management programs Clinical quality improvement Health care quality Utilization Provider network development Government programs Health financing Accreditation Standards +45
Exec Senior Full Time
USD 221K+
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Provider Engagement Account Manager
Remote-OK, United States Centene Corporation logo Centene Corporation
Cost and utilization Network performance Quality measures Utilization Provider education Provider engagement HEDIS Provider Relations Health Plan +28
Mid Full Time
USD 55K+
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Remote Medical Director - South Carolina
Remote-SC, United States Centene Corporation logo Centene Corporation
Utilization Medical management programs Clinical quality improvement Health care quality Government programs Provider network development Health financing Personnel management Accreditation Standards +39
Exec Mid Full Time
USD 221K+
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