Remote Jobs at Centene Corporation

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must reside in New Jersey for home visits within Monmouth and/or Middlesex County. Travel up to 75% required. Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. • Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome • Develops ongoing care plans / service plans and collaborates with providers to identify providers, ...

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. Position Purpose: Create and implement the enterprise provider strategy. Oversee network management training, providing support to all network staff. Oversee provider relations and provider communication and collaborate on policy and procedure development. • Create enterprise provider strategy development and implementation in support of contracting, network design, and provider experience • Oversee network management training in provider relations, contracting, provider engagement, and value-based contracting • Develop national provider relations policies and procedures and adapt for state specific requirements • Oversee provider communications and manuals based on regulations and policy changes • Provide new market support by liaising with business development and business integration to ensure the regulatory ...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Candidates MUST reside in North Carolina. Position Purpose: Supervise nurses in a highly regulated department responsible for performing medical necessity case reviews for appropriateness of medical care and service. Supervise the day to day clinical operations and functions within the department, ensuring productivity and quality metrics are met. • Provide oversight and interpretation of state/federal regulations and NCQA standards impacting member appeals and grievances from a clinical perspective. Ensure that the clinical Appeals and Grievance department processes all cases in accordance with policies and procedures • Utilize clinical expertise to serve as a resource to the team regarding escalated or comp ...