Director, Medical Management Operations
Centene Corporation
This is a Full-time position in Chicago, IL posted November 21, 2021.
Category Clinical & Care Management This job is available in 2 locations Full-time Job Id 1266246 Meridian Illinois
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:
Design, implement, evaluate, modify, and oversee specific Medical Management Operations within the corporation
- Oversee the centralized medical management operations including the development of key performance metrics, policies, procedures, workflows, training and auditing
- Monitor and manage workflow/work volumes in centralized medical management operations
- Evaluate existing medical management practices and identify best practices.
Collaborate with Health Plans to establish standardized “play books” to ensure effectiveness and efficiency
- Ensure new Health Plans’ medical management programs are integrated with existing Health Plans in terms of policies, procedures, workflows, reporting, auditing, etc.
- Explore new approaches to work processes by utilizing continuous process improvement techniques to eliminate waste and ensure resources are allocated to high value activities
- Collaborate with various departments within the Health Plans and corporation to ensure accreditation standards are achieved
- Lead cross functions work teams to design and implement new medical management programs
- Analyze data to make informed decisions regarding existing and new medical management programs Ability to travel up to 20-40%
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
Education/Experience:
Bachelor’s degree in Nursing or related field or equivalent experience.
7+ years of medical management experience.
Operational experience with program development and implementation, including development of key metrics, analysis of processes, and evaluation of outcomes.
Experience with continuous process improvement methodology.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Managed care experience preferred.
License/Certification:
Clinical Licensure 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.
“I work in a fast-paced, caring, collaborative and energetic environment.
Each day, I am given the opportunity to make a difference in the lives of our members.”
– Kevin E.
Murray, Resource Specialist,
SilverSummit Health Plan
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Category Clinical & Care Management Location Charlotte, North Carolina, US
Transforming the health of the community, one person at a time.
HEALTHCARE IS BEST DELIVERED LOCALLY
Our local approach allows us to help members access high-quality, culturally sensitive healthcare services.
The health of individuals drives our focus on the environment, removing social barriers to health, and prioritizing responsible corporate governance.
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