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Network Development Remote Jobs

168 fresh jobs found

Patient Care Specialist
Remote-FL, United States

Centene Corporation

Escalation process Order inquiries Pharmacy orders Outbound Calls Inbound Calls Telephonic Outreach Customer Care Accreditation Pharmacy +8

Entry Full Time

USD 53K+

Pharmacy Technician II
Remote-MI, United States

Centene Corporation

Prescription preparation Pharmacy Technician Health Services Medical management Accreditation Prior authorization Pharmacy Regulatory requirements Supervision +12

Entry Mid Full Time

USD 38K+

Manager, Strategic Provider Partnerships
Remote-OR, United States

Centene Corporation

Clinical workflow optimization Performance Insights Value-based contracting Member Outreach Utilization Provider engagement Health Plan Clinical Experience Healthcare administration +22

USD 86K+

Program Manager II - Medicare/Marketplace Claims
Remote-AZ, United States

Centene Corporation

Billing and reimbursement rules Program compliance Business process documentation Claims analysis Office Suite Business Process Microsoft Project Communication tools Provider engagement +58

USD 68K+

Contract Negotiator IV
Remote-TX, United States

Centene Corporation

Health care negotiations Provider contracts Operational reporting Performance Data Government programs Corrective action plans Field Work Contract Analysis Contract negotiations +24

USD 86K+

Clinical Review Nurse - Concurrent Review
Remote-IN, United States

Centene Corporation

Health management systems Concurrent review Health management Medicaid regulations Clinical Review Utilization Medical necessity Health Services Guidelines +22

USD 95K+

Senior Care Manager
Remote-FL, United States

Centene Corporation

Member education Personalized care plan Substance Use Disorders Treatment options Quality care Substance use Service coordination Home visits Healthcare Coordination +39

Senior Full Time

USD 73K+

LTSS Service Care Manager
Remote-NC, United States

Centene Corporation

Gerontology Holistic care management Service planning Holistic care Pediatrics Geriatrics Human services Healthcare Coordination Quality of care +29

USD 52K+

Business Analyst III
Remote-FL, United States

Centene Corporation

Software Enhancement Implementation processes Process redesign Operational performance Business Process Analysis Business solutions Business Process Data migration User Acceptance Testing +28

Senior Mid Full Time

USD 68K+

Business Analyst II
Remote-MO, United States

Centene Corporation

Software Enhancement Implementation processes Business Process Analysis Business solutions Business Process Data migration User Acceptance Testing Healthcare industry Procedures +24

Entry Mid Full Time

USD 55K+

Director, Change Communications
Remote-MO, United States

Centene Corporation

Strategic Communications Content Creation Health Insurance Stakeholder engagement Change Management Access Communications Flexibility Insurance +3

Exec Senior Full Time

USD 116K+

Product Operations Specialist
Remote-FL, United States

Centene Corporation

Operational performance Researching Tracking Reporting tools Business administration Root Cause Analysis Reports Health Insurance Access +23

USD 55K+

Sales Auditor
Remote-MI, United States

Centene Corporation

Call Center Software HIPAA regulations Tracking Audits Training Development Call Center Auditing Medicare HIPAA +16

USD 77K+

Director, Claims Configuration
Remote-MO, United States

Centene Corporation

Pricing setup Claims Payment Systems Business Requirements Gathering Health care administration Claims Configuration Provider contracts Claims payment Claims Adjudication Adjudication +19

Exec Senior Full Time

USD 145K+

Data Analyst III Healthcare Analytics
Remote-MO, United States

Centene Corporation

Claims pricing Microsoft powerbi Large databases Data verification Microsoft Power BI Clinical outcomes Claims payment Visualization Tools Utilization +57

Senior Mid Full Time

USD 68K+

Manager, Project Management
Remote-FL, United States

Centene Corporation

Healthcare initiatives Pharmacy services Project Management Software Lean Six Sigma Tracking Project management tools Project Planning PMP Six Sigma +29

USD 86K+

SIU Lead Investigator
Remote-PA, United States

Centene Corporation

Audit analysis Medical claims coding Xcelys Government programs Pharmacy Technician Medical claims Guidelines Microsoft Access Investigative +40

Senior Full Time

USD 68K+

Pediatric Care Manager RN
Remote-FL, United States

Centene Corporation

Pediatric care Digital Outreach Personalized care plans Complex Care Management Resource support Social determinants Service Assessment Foster care Social Determinants of Health +27

USD 55K+

Procurement Contracts Specialist III
Remote-FL, United States

Centene Corporation

Coupa Contract Lifecycle Management Health Plan Security policies Category management Contracting Procedures ServiceNow SharePoint +27

Senior Full Time

USD 68K+

Utilization Review Clinician - Behavioral Health
Remote-FL, United States

Centene Corporation

Medical appropriateness Concurrent review Healthcare Collaboration Treatment plans Clinical Review Utilization Guidelines Health Services Medical management +23

USD 52K+

Operations Auditor II
Remote-FL, United States

Centene Corporation

Corrective Actions Applied Behavioral Analysis Behavioral Analysis ABA Accreditation Healthcare Compliance Credentialing Information systems Procedures +25

USD 55K+

Contract Negotiator I
Remote-TX, United States

Centene Corporation

Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Guidelines Provider Relations Health Plan Healthcare administration +21

Entry Mid Full Time

USD 55K+

Utilization Review Clinician - Behavioral Health (Sat-Wed Shift)
Remote-FL, United States

Centene Corporation

Medical appropriateness Concurrent review Healthcare Collaboration Treatment plans Clinical Review Utilization Guidelines Health Services Medical management +23

USD 52K+

Care Manager (RN) - Essex and/or Union County
Remote-NJ, United States

Centene Corporation

Resource Coordination Home visits Personalized care plans Social determinants Complex Care Management Resource support Service Assessment Social Determinants of Health Foster care +29

USD 55K+

Vice President, Finance
Remote-WI, United States

Centene Corporation

Cost improvement Reporting strategy Cost trends Pricing models Health Plan Financial Procedures Business administration Pricing +20

USD 165K+

Provider Engagement Network Specialist
Remote-WA, United States

Centene Corporation

Network reporting Provider directories Demographic information changes Provider information system Claims payment Medical claims Provider education Provider engagement Spreadsheets +23

USD 44K+

Senior Vice President, Network Development & Contracting
Remote-MO, United States

Centene Corporation

Contracting management Provider Contracting Medical Services Network development Contract Analysis Provider Relations Market Expansion Contract negotiations Healthcare administration +29

Exec Senior Full Time

USD 350K+

Public Programs Specialist
Remote-CA, United States

Centene Corporation

Member services Member access Provider network management Health care services Grievances Clinical Management Pharmacy Technician Medical Review Service coordination +27

Entry Mid Full Time

USD 77K+

Manager, Strategic Provider Partnerships
Remote-OH, United States

Centene Corporation

Performance Insights Value-based contracting Member Outreach Utilization Provider engagement Health Plan Healthcare administration Clinical Experience Performance Improvement +23

USD 86K+

Accountant I
Remote-AR, United States

Centene Corporation

Cash Management Advanced Excel Journal entries Financial Accounts Receivable Health care Reports Financial reporting Health Insurance +15

Entry Mid Full Time

USD 44K+

Care Management Support Coordinator II
Remote-NY, United States

Centene Corporation

Health Plan Knowledge Social determinants Guidelines Social Determinants of Health Inbound Calls Regulatory Guidelines Health Plan Customer Care Community Resources +19

Entry Mid Full Time

USD 55K+

Care Manager (RN) - Middlesex and/or Union County
Remote-NJ, United States

Centene Corporation

Home visits Care Planning Personalized care plans Complex Care Management Social determinants Resource support Service Assessment Foster care Social Determinants of Health +29

USD 55K+

Quality Practice Advisor
Remote-IN, United States

Centene Corporation

Risk Adjustment Coding Cphq Performance Data Medical record documentation Provider education Provider Relations NCQA ICD-9 Guidelines +26

USD 52K+

Utilization Review Clinician - Behavioral Health
Remote-AL, United States

Centene Corporation

Treatment assessment Medical appropriateness Concurrent review Healthcare Collaboration Treatment plans Clinical Review Provider education Utilization Guidelines +26

USD 52K+

Care Manager (RN) - Middlesex and/or Monmouth County
Remote-NJ, United States

Centene Corporation

Resource Coordination Home visits Personalized care plans Social determinants Complex Care Management Resource support Service Assessment Social Determinants of Health Foster care +29

USD 55K+

Senior IAM Analyst
Remote-FL, United States

Centene Corporation

SailPoint IIQ Technical Design Documentation Public Key Infrastructure Identity solutions Provisioning Sailpoint Health outcomes RBAC Soft +49

Senior Mid Full Time

USD 73K+

Quality Program Strategist II
Remote-MO, United States

Centene Corporation

Performance goals CAHPS HOS Quality performance Cphq HEDIS Health Plan Clinical Experience Cross-functional Teams +30

USD 68K+

Compliance Internal Auditor
Remote-FL, United States

Centene Corporation

Internal Audits Internal Auditing Audit planning Accounting Principles Public Accounting Audits Risk mitigation Health care Reports +21

Entry Mid Full Time

USD 55K+

Medical Management Auditor - Behavioral Health
Remote-FL, United States

Centene Corporation

Clinical Systems System Maintenance InterQual Corrective Actions Medical management Appeals Health Plan Credentialing Problem Resolution +18

USD 55K+

Bilingual Customer Service Advocate I
Remote-NC, United States

Centene Corporation

CRM applications Tracking Contact center Customer Care Performance Tracking Quality Standards Multitasking Assessment Bilingual +15

Entry Full Time

USD 32K+

Provider Engagement Administrator II
Remote-NJ, United States

Centene Corporation

Claims reimbursement Claims billing Cost and utilization Claims Submission Network performance Provider education Utilization Provider Relations Provider engagement +30

USD 55K+

Provider Network Specialist II
Remote-NJ, United States

Centene Corporation

Provider performance metrics Health information exchange Contracting duties Health plan provider orientations Credentialing documentation Educational outreach Quality performance Provider network management Managed healthcare +30

USD 55K+

Manager, Operations (Medicaid / FIDE SNP)
Remote-NJ, United States

Centene Corporation

Xcelys Pricing Configuration Total quality management Amisys Data Sources Benefits management Matrix Environment Tracking Methodologies +33

USD 86K+

Care Manager (RN) - Mercer and/or Somerset County
Remote-NJ, United States

Centene Corporation

Education facilitation Compliance Documentation Digital Outreach Home visits Personalized care plans Social determinants Complex Care Management Resource support Service Assessment +28

USD 55K+

Care Manager (RN)
Remote-MO, United States

Centene Corporation

Digital Outreach Personalized care plans Social determinants Complex Care Management Resource support Service Assessment Social Determinants of Health Foster care Service plan +26

USD 55K+

Senior Data Engineer - IDMC
Remote-MO, United States

Centene Corporation

Data Staging Data reliability Data destruction Data provisioning Programming concepts Data Pipeline Optimization Python programming Real-time processing Performance Data +52

Senior Mid Full Time

USD 85K+

Business Technical Analyst
Remote-FL, United States

Centene Corporation

Database Solutions VB.NET Corrective Actions ASP.NET System Analysis Financial SAS Procedures System design +26

Entry Mid Full Time

USD 68K+

Finance Analyst III - Hybrid
Remote-OH, United States

Centene Corporation

Finance analysis Statistical reporting Financial data analysis MicroStrategy PeopleSoft Microsoft Access OneStream General Ledger Data Warehouse +26

Senior Mid Full Time

USD 68K+

Care Manager (RN) - Bergen and/or Passaic County
Remote-NJ, United States

Centene Corporation

Member assessment Home visits Personalized care plans Social determinants Complex Care Management Resource support Service Assessment Foster care Social Determinants of Health +28

USD 55K+

Quality Practice Advisor
Remote-OK, United States

Centene Corporation

Performance Data Cphq Medical record documentation Risk Adjustment Coding Provider education Guidelines Provider Relations ICD-9 NCQA +26

USD 95K+

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