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Centene Corporation
- Woodland Hills, CA / Rancho Cordova, CA / Tampa, FL / 16 more...
Identify, negotiate and manage high performing provider and vendor partnerships. Negotiate vendor or provider contracts and manage implementations and ongoing relationships. Perform market research and analysis as directed. Define, initiate, and direct financial analyses and operational reporting for the assigned vendor and provider agreements. Lead, manage, and track ongoing financial and operati
Posted 11 days ago
Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess a
Posted 19 days ago
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosi
Posted 1 month ago
Assist in maintaining Centene Corporation's Compliance Program; guide special projects; provide regulatory interpretation; perform compliance reporting; develop and implement compliance auditing an monitoring. Serve as a company wide resource and liaison on policies, contract issues and provisions, communications, workflow and quality improvements initiatives. Communicate state and federal require
Posted 1 month ago
Identify, negotiate and manage high performing provider and vendor partnerships. Negotiate vendor or provider contracts and manage implementations and ongoing relationships. Perform market research and analysis as directed. Define, initiate, and direct financial analyses and operational reporting for the assigned vendor and provider agreements. Lead, manage, and track ongoing financial and operati
Posted 2 months ago
Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess a
Posted 2 months ago
Identify, negotiate and manage high performing provider and vendor partnerships. Negotiate vendor or provider contracts and manage implementations and ongoing relationships. Perform market research and analysis as directed. Define, initiate, and direct financial analyses and operational reporting for the assigned vendor and provider agreements. Lead, manage, and track ongoing financial and operati
Posted 2 months ago
Lead analytical data needs for all HP's and business units. Initiate and lead company wide data processes improvements Lead cross functional activities related to large scale analytic projects to deliver on schedule, within budget and with superior quality Develop and lead activities to accomplish overall strategic department goals and lead the communication of these goals to stakeholders at all l
Posted 3 months ago
Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions, monitor quality of care, collect and analyze utilization and cost of care data, assist with discharge planning, arrange transportation; provide
Posted 4 months ago
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