Position Purpose: Perform collaborative duties for the development and implementation of all Coordinated Care programs (OB/NICU, Asthma, Diabetes, ER, General/Catastrophic); Provide support and supervision to ensure quality and continuity of services delivered to Members, Providers and staff.
Develop and oversee aspects of coordinated care program activities
Develop and implement management software and reporting mechanisms for specific outcome measurement and data reporting
Identify referrals for coordinated care programs.
Develop plan specific literature and educational components for member and provider distribution.
Oversee contract negotiation and execution components for Prenatal Coordinated Care (PNCC) entities
Collaborate with various departments to extract data for identification of program members and to report program outcomes
Identify processes and work flow improvements to foster efficient and effective case management efforts
Monitor distribution of members identified for case management to ensure positive results and program success
Education/Experience: High school diploma or equivalent. 5 years of prior authorization, physician's office, customer service, claims processing or provider relations experience preferably in a managed care setting. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.
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.