Centene Corporation

Clinician Specialist

Centene Corporation · Full Time · 2 days ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Others

The Clinician Specialist provides clinical and operational support for utilization and case management, including the development and monitoring of clinical guidelines and policies. They also oversee the creation of member and provider communications while ensuring regulatory compliance and operational efficiency.

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RN Supervisor, Appeals, Managed Care, UM

Centene Corporation · Full Time · 2 days ago

Centene Corporation

🌎 Azerbaijan, Bermuda, Cayman Islands, Israel, Tunisia, United States 💵 $75300 - $135K per year ⭐ 2-5 yrs exp 💼 Healthcare

Supervises the utilization management team to ensure adherence to performance, compliance, and quality standards for prior authorization and clinical reviews. Collaborates with senior management to develop policies and provides coaching to team members to facilitate process improvements.

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Sr. Clinical Technology Portfolio Owner-UM Correspondence

Centene Corporation · Full Time · 2 days ago

Centene Corporation

🌎 United States 💵 $107K - $199K per year ⭐ 5-10 yrs exp 💼 Healthcare

The role involves owning the end-to-end product strategy for clinical technology and correspondence platforms while analyzing business objectives to define requirements. You will lead cross-functional teams to build modular solutions, manage product backlogs, and ensure all implementations align with regulatory and clinical standards.

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Care Coordinator II

Centene Corporation · Full Time · 2 days ago

Centene Corporation

🌎 United States 💵 $17.84 - $28.02 per hour ⭐ 0-2 yrs exp 💼 Healthcare

The Care Coordinator supports care management activities by performing member outreach, conducting home visits, and documenting care plans. They coordinate services with healthcare providers and community partners to ensure continuity of care and member satisfaction.

behavioral-health

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Program Manager IV (Gold Card Program)

Centene Corporation · Full Time · 2 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 10+ yrs exp 💼 Product

The Program Manager leads large-scale, cross-functional initiatives for Gold Card programs, overseeing planning, execution, and operational readiness. They are responsible for managing budgets, risks, and dependencies while providing executive-level reporting and ensuring regulatory compliance.

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Grievance & Appeals Coordinator I

Centene Corporation · Full Time · 2 days ago

Centene Corporation

🌎 United States 💵 $19.43 - $32.98 per hour ⭐ 2-5 yrs exp 💼 Others

The role involves analyzing and resolving claims and authorization appeals while managing formal grievances from members and providers. Additionally, the coordinator will support pay-for-performance programs and assist with HEDIS production functions.

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Manager, Finance

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Finance

The manager will oversee financial planning, forecasting, and reporting while leading a team of financial analysts to drive operational accountability. They are responsible for analyzing complex financial data and partnering with business leaders to support healthcare service effectiveness.

business-operations operations leadership

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Utilization Review Clinician - Behavioral Health

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $27.02 - $48.55 per hour ⭐ 2-5 yrs exp 💼 Healthcare

The clinician performs medical necessity reviews and authorization determinations to ensure members receive appropriate behavioral health services. They also monitor care, conduct concurrent reviews for inpatient stays, and collaborate with providers and medical directors to improve care quality.

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Supervisor, Claims

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $27.02 - $48.55 per hour ⭐ 2-5 yrs exp 💼 Legal

The Supervisor oversees daily claims operations, providing technical support and leadership to ensure accurate and timely processing. They are responsible for implementing policies, managing inventory, and driving operational excellence through reporting and process improvements.

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Senior Marketing & Communication Specialist

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Marketing

The specialist will assist in planning and implementing state-wide marketing and communication programs while managing promotional materials and community outreach. They are also responsible for training staff, ensuring budget compliance, and representing the company to the public.

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Care Manager (RN) - Foster Care

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Care Manager develops and facilitates complex care management activities, including personalized care plans and education for members and their families. They also coordinate with providers and community resources to address unmet needs and ensure timely access to healthcare services.

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Finance Analyst III

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Finance

The Finance Analyst III will support financial performance and operational analytics by compiling and analyzing complex data sets. They will build recurring reports, create executive-ready presentations, and translate financial insights into actionable recommendations for leadership.

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IT Auditor II

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Finance

Perform internal audits including information technology, strategic, operational, and compliance risk-based audits. Assist in audit planning, drafting reports, and communicating findings and recommendations to management.

compliance

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Remote Medical Director, Marketplace

Centene Corporation · Full Time · 3 days ago

Centene Corporation

🌎 United States 💵 $236K - $449K per year ⭐ 10+ yrs exp 💼 Healthcare

The Medical Director assists in coordinating medical management, quality improvement, and credentialing functions while providing clinical leadership for utilization management and cost-containment activities. They also collaborate with clinical teams and providers to optimize patient outcomes and ensure compliance with regulatory and accreditation standards.

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Supervisor, Payment Integrity- Coding & Clinical (DRG)

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Healthcare

Supervise and coordinate the daily activities of the Coding & Clinical Review team to ensure accurate DRG assignment, clinical validation, and audit outcomes. Monitor team performance, provide guidance on complex coding determinations, and implement departmental strategies to improve operational efficiency and quality.

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Supervisor, Payment Integrity- Coding & Clinical (DRG)

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Healthcare

Supervise and coordinate the daily activities of the Coding & Clinical Review team to ensure accurate DRG assignment, clinical validation, and audit outcomes. Monitor team performance, provide guidance on complex coding matters, and ensure compliance with regulatory and organizational standards.

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Care Manager (RN)

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Healthcare

Develops, assesses, and facilitates complex care management activities to provide high-quality, cost-effective healthcare outcomes for members. Coordinates care plans, monitors member status, and collaborates with providers and families to address unmet needs and barriers to care.

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Utilization Review Clinician - ABA

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $27.02 - $48.55 per hour ⭐ 2-5 yrs exp 💼 Others

The clinician performs medical appropriateness reviews for Applied Behavioral Analysis (ABA) services and monitors the clinical effectiveness of member care. They also interact with healthcare providers to discuss care levels and provide education to members and families regarding the utilization process.

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Utilization Review Clinician - ABA

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $27.02 - $48.55 per hour ⭐ 2-5 yrs exp 💼 Others

The clinician performs utilization reviews of Applied Behavioral Analysis (ABA) services to determine medical appropriateness and clinical effectiveness. They also interact with healthcare providers and provide education to members and families regarding the behavioral health utilization process.

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Care Navigator

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $22.94 - $38.79 per hour ⭐ 2-5 yrs exp 💼 Others

The Care Navigator develops and coordinates personalized care plans to improve healthcare outcomes for members. They provide psychosocial support and facilitate access to community resources such as housing, education, and foster care services.

compliance

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Project Manager II - Payment Integrity

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 Bermuda, Israel, United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Product

The Project Manager will plan, organize, and oversee cross-functional projects to meet strategic objectives throughout the full project life cycle. They are responsible for managing budgets, resources, project documentation, and communicating status updates to stakeholders.

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Care Manager (RN)

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Care Manager develops and facilitates complex care management activities to provide high-quality, cost-effective healthcare outcomes for members. They collaborate with providers and families to create personalized care plans, monitor member progress, and address barriers to care.

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Care Navigator

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $22.94 - $38.79 per hour ⭐ 2-5 yrs exp 💼 Others

The Care Navigator develops and coordinates personalized care plans to improve health outcomes and access to services for members. They provide psychosocial support, facilitate resource identification, and maintain documentation to ensure compliance with regulatory standards.

compliance

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Manager, Marketing & Communications

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Marketing

Manage state-wide marketing, communications, and preventive health education initiatives while ensuring compliance with corporate and state standards. Oversee the production of member materials, serve as a media spokesperson, and foster relationships with community organizations.

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Finance Analyst II

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Finance

The Finance Analyst II will compile and analyze labor financial information, including contractor costs, project costing, and professional services spend. They will also develop financial models, prepare journal entries, and partner with business leaders to support labor demand and funding requirements.

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Senior Business Process Consultant

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

The Senior Business Process Consultant leads cross-functional initiatives and business case development to drive performance improvement and strategic alignment. They are responsible for organizing work teams, performing detailed data and workflow analysis, and ensuring effective implementation of business policies.

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Compliance Officer - New Jersey

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $148K - $274K per year ⭐ 10+ yrs exp 💼 Legal

Provide strategic leadership and oversight for the health plan compliance program, including regulatory strategy, policy development, and cross-functional implementation. Serve as the senior compliance leader for state interactions, audits, and risk management activities across the New Jersey market.

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Medical Director

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $225K - $428K per year ⭐ 10+ yrs exp 💼 Healthcare

The Medical Director assists in directing and coordinating medical management, quality improvement, and credentialing functions for the business unit. They provide medical leadership for utilization management, cost containment, and collaborate with clinical teams to optimize outcomes for high-risk patients.

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Behavioral Health Medical Director

Centene Corporation · Full Time · 4 days ago

Centene Corporation

🌎 United States 💵 $225K - $428K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Behavioral Health Medical Director provides clinical leadership for medical management, quality improvement, and utilization review functions. They collaborate with clinical teams and providers to optimize care for high-risk patients and ensure compliance with regulatory and accreditation standards.

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Senior Benefits Analyst - ICHRA

Centene Corporation · Full Time · 5 days ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Finance

The Senior Benefits Analyst will research, design, and administer ICHRA and multi-state employee benefit plans while ensuring legal compliance and standardization. They will also manage carrier relationships, resolve complex benefit issues, and conduct regulatory filings such as 5500s and audits.

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Utilization Review Clinician - Behavioral Health

Centene Corporation · Full Time · 5 days ago

Centene Corporation

🌎 United States 💵 $27.02 - $48.55 per hour ⭐ 2-5 yrs exp 💼 Healthcare

The clinician performs clinical reviews to assess the medical appropriateness of mental health and substance abuse services before, during, and after treatment. They also engage with providers and medical directors to improve care quality, efficiency, and discharge planning.

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Director, Clinical Training

Centene Corporation · Full Time · 5 days ago

Centene Corporation

🌎 United States 💵 $118K - $219K per year ⭐ 5-10 yrs exp 💼 Healthcare

Direct and oversee all training activities, including assessment, material development, and facilitation across the business unit. Collaborate with management and HR to identify organizational gaps, implement training initiatives, and evaluate program effectiveness and ROI.

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Medical Director

Centene Corporation · Full Time · 5 days ago

Centene Corporation

🌎 United States 💵 $215K - $408K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Medical Director assists in directing and coordinating medical management, quality improvement, and credentialing functions for the business unit. They provide medical leadership for utilization management, cost containment, and collaborate with clinical teams to optimize patient outcomes.

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Manager, Special Investigation Unit (SIU)

Centene Corporation · Full Time · 5 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 2-5 yrs exp 💼 Others

The manager will develop and implement strategic fraud, waste, and abuse activities while monitoring business processes to ensure billing and claims integrity. They will also lead an investigation team, prepare saving reports, and participate in interdepartmental meetings.

medical compliance

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Care Navigator - Foster Care

Centene Corporation · Full Time · 5 days ago

Centene Corporation

🌎 United States 💵 $22.94 - $38.79 per hour ⭐ 2-5 yrs exp 💼 Others

Develops and coordinates personalized care plans to improve healthcare outcomes for members. Provides psychosocial support and facilitates access to community resources such as housing, education, and foster care services.

compliance

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Care Navigator - Foster Care

Centene Corporation · Full Time · 6 days ago

Centene Corporation

🌎 United States 💵 $22.94 - $38.79 per hour ⭐ 2-5 yrs exp 💼 Others

Develops and coordinates personalized care plans to provide quality, cost-effective healthcare outcomes for members. Provides psychosocial support and connects members with community resources such as housing, education, and foster care.

compliance

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Lead SIU Investigator

Centene Corporation · Full Time · 6 days ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 5-10 yrs exp 💼 Others

The Lead SIU Investigator acts as a subject matter expert, providing guidance to staff while managing complex investigations into fraud, waste, and abuse. They are responsible for identifying trends, developing investigative plans, and ensuring compliance with federal and state regulations.

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Senior Provider Engagement Network Specialist

Centene Corporation · Full Time · 9 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 5-10 yrs exp 💼 Others

Ensure providers are accurately set up in information systems for state reporting, claims payment, and directories. Act as the primary liaison and account manager for providers to resolve complex contract and data issues.

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Medical Director

Centene Corporation · Full Time · 9 days ago

Centene Corporation

🌎 United States 💵 $236K - $449K per year ⭐ 10+ yrs exp 💼 Healthcare

The Medical Director directs medical management, quality improvement, and credentialing functions while providing leadership for utilization review and cost containment. They perform medical reviews of complex cases and collaborate with clinical teams to optimize outcomes for high-risk patients.

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Care Navigator - Foster Care

Centene Corporation · Full Time · 9 days ago

Centene Corporation

🌎 United States 💵 $22.94 - $38.79 per hour ⭐ 2-5 yrs exp 💼 Others

Develops and coordinates personalized care plans for members to ensure quality and cost-effective healthcare outcomes. Provides psychosocial support and connects members with community resources such as housing, education, and foster care services.

behavioral-health compliance

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Vice President, Legislative & Government Affairs .

Centene Corporation · Full Time · 10 days ago

Centene Corporation

🌎 United States 💵 $180K - $343K per year ⭐ 5-10 yrs exp 💼 Others

Serve as a liaison to state government entities to improve the legislative and regulatory environment for Centene and its health plans. Develop strategic relationships with policymakers and represent the organization to trade groups and stakeholders to shape public policy.

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Payment Integrity Specialist - Regulatory

Centene Corporation · Full Time · 10 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Legal

The role leads business case development and manages large-scale, cross-functional initiatives to drive financial gains and compliance. It involves analyzing data and workflows to implement process improvements and providing strategic guidance across the organization.

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Manager, Provider Data Management

Centene Corporation · Full Time · 11 days ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Data Entry

Manage provider data management projects, policies, and directories to support successful claims adjudication and operational efficiency. Supervise staff performance and collaborate with internal departments and IT to implement business application changes.

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Community Resource Coordinator II

Centene Corporation · Full Time · 11 days ago

Centene Corporation

🌎 United States 💵 $17.84 - $28.02 per hour ⭐ 0-2 yrs exp 💼 Others

Connects members to community resources and provides health education to support their care management journey. Conducts non-clinical assessments and outreach to locate hard-to-reach families and individuals.

medical

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Provider Reimbursement Specialist

Centene Corporation · Full Time · 11 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Others

Maintains relationships with healthcare providers and acts as the primary contact for complex claims projects and non-routine issues. Researches and resolves claims discrepancies while facilitating process improvement initiatives and reporting quality outcomes to management.

medical data-management

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Quality Trainer I

Centene Corporation · Full Time · 16 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Teaching

Develop and conduct training programs and auditing tools for provider-facing staff regarding quality programs and workflows. Collaborate with subject matter experts to create interactive learning experiences and maintain up-to-date training resources.

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Psychologist Reviewer

Centene Corporation · Full Time · 18 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 2-5 yrs exp 💼 Healthcare

Authorize and monitor care for behavioral health and substance abuse cases based on medical necessity and internal criteria. Conduct peer reviews with clinical professionals and provide education to network practitioners on best practice models.

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Senior Business Solutions Architect

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 United States 💵 $107K - $199K per year ⭐ 5-10 yrs exp 💼 Software Development

Lead the transformation of business strategy by designing solutions and estimating value realization for organizational initiatives. Partner with senior leadership to create business architecture models and maintain governance across delivery groups.

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Enterprise Engagement Lead Analyst

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 Canada, United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

Translates complex regulatory, legislative, and contractual requirements into actionable risk-informed analysis and advisory outputs. Supports Enterprise Engagement Officers by delivering high-quality insights and maintaining requirement inventories to ensure operational compliance.

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Enterprise Engagement Lead Analyst

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 Canada, United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

Translates complex regulatory, legislative, and contractual requirements into actionable risk-informed analysis and advisory outputs for the Enterprise Privacy & Security Risk Management team. Supports Enterprise Engagement Officers by delivering high-quality analysis, requirement traceability, and executive-ready insights to operationalize compliance across the enterprise.

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Principal Incident Response Analyst

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 United States 💵 $121K - $224K per year ⭐ 5-10 yrs exp 💼 Teaching

Executes the enterprise-wide Incident Response Plan and implements security service audit schedules to identify shortfalls. Collaborates with security architects and engineers to integrate third-party threat reporting into internal CIRT systems.

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Enterprise Engagement Lead Analyst

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 Canada, United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

Translates complex regulatory, legislative, and contractual requirements into actionable risk-informed analysis and advisory outputs. Supports Enterprise Privacy & Security Risk Management by maintaining requirement inventories and delivering executive-ready insights to stakeholders.

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Enterprise Engagement Lead Analyst

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 Canada, United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

Translates complex regulatory, legislative, and contractual requirements into actionable risk-informed analysis and advisory outputs for the Enterprise Privacy & Security Risk Management team. Supports Enterprise Engagement Officers by delivering executive-ready insights, requirement mappings, and impact assessments to ensure operational compliance.

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Enterprise Engagement Lead Analyst

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

Translates complex regulatory, legislative, and contractual requirements into actionable risk analysis and advisory outputs for the Enterprise Privacy & Security Risk Management team. Supports Enterprise Engagement Officers by delivering executive-ready insights and maintaining requirement inventories to ensure operational compliance.

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Remote Behavioral Medical Director, Central Region

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 Bermuda, United States 💵 $236K - $449K per year ⭐ 10+ yrs exp 💼 Healthcare

Direct and coordinate medical management, quality improvement, and credentialing functions to optimize member care and cost-effectiveness. Perform medical reviews of complex cases and provide leadership for utilization management and regulatory compliance.

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Remote Medical Director, Appeals

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 Azerbaijan, United States 💵 $236K - $449K per year ⭐ 10+ yrs exp 💼 Healthcare

Directs medical management, quality improvement, and credentialing functions to optimize care and cost-effectiveness for members. Performs complex medical reviews and provides leadership for utilization management and medical necessity appeals.

medical leadership organization

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Remote Behavioral Medical Director, Eastern Region

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 United States 💵 $236K - $449K per year ⭐ 10+ yrs exp 💼 Healthcare

Direct and coordinate medical management, quality improvement, and credentialing functions to optimize care for members. Provide medical leadership for utilization review and cost containment while collaborating with clinical teams and providers.

medical leadership organization

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Psychologist Reviewer

Centene Corporation · Full Time · 19 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 2-5 yrs exp 💼 Healthcare

Authorize and monitor behavioral health care for members based on clinical information and medical necessity criteria. Conduct peer reviews and collaborate with network practitioners and medical directors to ensure high-quality care for individuals with Autism.

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Director, Utilization Management Hospice CoE

Centene Corporation · Full Time · 20 days ago

Centene Corporation

🌎 United States 💵 $133K - $247K per year ⭐ 10+ yrs exp 💼 Healthcare

Directs the enterprise strategy and operational execution of hospice and palliative care utilization management for Medicaid and Marketplace populations. Oversees clinical governance, budget components, and team performance to ensure high-quality member outcomes and regulatory compliance.

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Senior Business Technical Analyst

Centene Corporation · Full Time · 22 days ago

Centene Corporation

🌎 United States 💵 $87700 - $157K per year ⭐ 5-10 yrs exp 💼 Others

Translate Medicare Advantage and Medicaid Risk Adjustment business requirements into technical specifications and production-ready SAS and Snowflake solutions. Modernize legacy ETL workflows into scalable Snowflake architecture while ensuring data quality and regulatory compliance for CMS audits.

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Quality Performance Clinical Pharmacist

Centene Corporation · Full Time · 23 days ago

Centene Corporation

🌎 United States 💵 $107K - $199K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Pharmacy Quality Performance Manager partners with health plans and provider groups to drive and accelerate pharmacy quality measures across various lines of business. They provide clinical expertise, develop performance reviews, and coordinate enterprise-wide quality initiatives.

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Associate Actuary

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 Azerbaijan, Tunisia, United States 💵 $87700 - $157K per year ⭐ 2-5 yrs exp 💼 Finance

Conduct pricing and risk assessments to estimate financial outcomes and manage actuarial needs for specific health plans. Support Value-Based Care strategies by developing financial models and analyzing healthcare datasets to track performance.

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Manager, Actuarial Services

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 Azerbaijan, Tunisia, United States 💵 $134K - $249K per year ⭐ 5-10 yrs exp 💼 Others

Lead the development of financial models and risk assessments to optimize Value-Based Care strategies and vendor arrangements. Collaborate with internal partners to ensure health plan operations are analytically sound and financially viable.

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Account Executive II (Specialty Pharmacy)

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Sales

Represent the company to prospective and existing clients to drive sales of pharmacy services and medical supplies. Monitor client satisfaction and collaborate with internal departments to resolve issues and maintain strong professional relationships.

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Care Manager

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Healthcare

Develops and facilitates complex care management plans for members with mental and behavioral health needs. Coordinates between members, families, and providers to ensure access to cost-effective healthcare and community resources.

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Senior Actuarial Analyst

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 Azerbaijan, Tunisia, United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Finance

Assist in financial analysis, pricing, and risk assessment to estimate outcomes for Value-Based Care initiatives. Develop financial models and analyze healthcare datasets to track performance and establish baselines.

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Director, LTSS Clinical Care Management

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 United States 💵 $127K - $236K per year ⭐ 10+ yrs exp 💼 Healthcare

Directs long-term care management for members with physical and behavioral health needs to ensure high-quality, cost-effective outcomes. Leads the design, implementation, and growth of LTSS programs while overseeing staff caseloads and regulatory compliance.

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Senior Security Governance Program Manager - Secure Configuration & Asset Management

Centene Corporation · Full Time · 24 days ago

Centene Corporation

🌎 United States 💵 $107K - $199K per year ⭐ 10+ yrs exp 💼 Product

Lead the development and maintenance of security governance pillars, focusing on cloud security, metrics, and asset management. Manage the lifecycle of security risk remediation and oversee the design and evaluation of enterprise security controls.

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Psychologist Reviewer

Centene Corporation · Full Time · 25 days ago

Centene Corporation

🌎 Canada, Cayman Islands, United States 💵 $87700 - $157K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Psychologist Reviewer will authorize, direct, and monitor care for behavioral health and substance abuse problems. They will conduct peer reviews and interact with network practitioners to provide education on best practices.

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Senior HEDIS Quality & Audit Analyst

Centene Corporation · Full Time · 25 days ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 2-5 yrs exp 💼 Others

The Senior Analyst serves as a subject matter expert leading complex HEDIS audit workstreams and ensuring audit-defensible documentation in alignment with NCQA and CMS expectations. They are responsible for mitigating audit risks, interpreting regulatory requirements, and driving continuous improvement in submission accuracy.

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DRG Reviewer

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $70100 - $126K per year ⭐ 5-10 yrs exp 💼 Others

Independently conduct comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure accurate reimbursement and compliance. Collaborate with the Medical Director on complex cases and develop medical policies to resolve ambiguities in clinical guidelines.

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Inpatient Utilization Review Clinician, Behavioral Health

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $27.02 - $48.55 per hour ⭐ 2-5 yrs exp 💼 Healthcare

Performs clinical reviews and assessments for mental health and substance abuse services to ensure medical appropriateness. Manages prior authorizations, concurrent reviews for inpatient care, and collaborates with providers and medical directors to improve care quality.

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Care Navigator

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $22.94 - $38.79 per hour ⭐ 2-5 yrs exp 💼 Others

Develops and coordinates personalized care plans to ensure members receive quality, cost-effective healthcare outcomes. Facilitates access to community resources and provides psychosocial support to members and their caregivers.

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Senior Communications Specialist

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 2-5 yrs exp 💼 Writing

Develop and distribute clear, compliant communication materials to support the national Gold Card program. Coordinate with subject matter experts and external vendors to ensure accurate information is delivered to providers and internal stakeholders.

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Behavioral Health Medical Director

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $236K - $449K per year ⭐ 10+ yrs exp 💼 Healthcare

Directs medical management, quality improvement, and credentialing functions to optimize care and cost-effectiveness for members. Performs complex medical reviews and provides leadership for utilization management and performance improvement initiatives.

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Supervisory Medical Director, National Physical Health Appeals Outpatient UM

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 Azerbaijan, United States 💵 $236K - $449K per year ⭐ 5-10 yrs exp 💼 Healthcare

Provides medical leadership and operational oversight for a team of medical directors to ensure high-quality, cost-effective care. Manages complex utilization review cases and oversees the appeals process in compliance with regulatory requirements.

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Senior Manager, Privacy & Security Regulatory Engagement

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 Canada, United States 💵 $107K - $199K per year ⭐ 10+ yrs exp 💼 Legal

Leads a team of regulatory analysts to translate complex privacy, security, and AI requirements into actionable risk-informed analysis for the organization. Partners with Enterprise Engagement Officers to drive contract analysis, readiness reviews, and continuous improvement of compliance frameworks.

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Vice President, Clinical Technology UM Portfolio Management

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $188K - $359K per year ⭐ 10+ yrs exp 💼 Healthcare

Oversee the clinical technology UM portfolio, driving product vision, strategy, and the deployment of AI-enabled capabilities across the UM lifecycle. Lead enterprise governance and partner with vendors to align roadmap priorities and measure financial performance and ROI.

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Privacy & Security Enterprise Engagement Officer

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 Canada, United States 💵 $107K - $199K per year ⭐ 10+ yrs exp 💼 Others

Translates privacy, security, and AI requirements from contracts and laws into actionable enterprise controls. Builds relationships with leadership to ensure compliance reporting, audit readiness, and continuous improvement across health plans.

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Privacy & Security Enterprise Engagement Officer

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 Canada, United States 💵 $107K - $199K per year ⭐ 10+ yrs exp 💼 Others

The role partners with Health Plans and Shared Services to translate privacy, security, and AI requirements from contracts and laws into actionable enterprise controls. It involves managing compliance evidence, driving early engagement with risk management, and ensuring audit readiness across the organization.

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SIU Investigator

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 United States 💵 $56200 - $101K per year ⭐ 0-2 yrs exp 💼 Others

Investigate allegations of healthcare fraud, waste, and abuse through claims audits and data mining. Prepare detailed investigative reports for referral to state and federal agencies.

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Associate Actuary, Strategic Analytics

Centene Corporation · Full Time · a month ago

Centene Corporation

🌎 Azerbaijan, Tunisia, United States 💵 $87700 - $157K per year ⭐ 2-5 yrs exp 💼 Software Development

The role involves designing and implementing actuarial methodologies to measure the financial impact of Value-Based Care and Quality and Affordability Initiatives. The Associate Actuary will serve as a strategic liaison, translating complex financial data into narratives for executive stakeholders.

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