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.Position Purpose: Lead and direct process improvement activities that provide more efficient and streamlined workflow between the market Population Health Clinical Operations (PHCO) and the Utilization Management (UM) Shared Services leadership. Scope includes best practice gathering/sharing, liaison for communication cascade and/or escalations, routing market specific issues to appropriate teams, fostering a strong and collaborative partnership between SS and markets.
Communicates key initiatives, performance metrics, and progress in oversight meetings with market leadership or other key organizational stakeholders.
Work as liaison between UM leaders and local market(s).
Gather and document local market business requirements and insight sharing for operational use, operational reference, and assistance in initiative, policy and procedure development.
Contribute local and regional insight to UM team for policy and processes development communicates changes to local market leadership to assist with approval where needed.
Resource to receive high priority local market UM concerns and work with UM team for resolution, communicating back to the local market leaders.
Education/Experience: Bachelor’s degree in Nursing, Healthcare Administration, Business or related field or equivalent experience. 7+ years of experience in utilization management and health insurance. 1-3 years of supervisory/management experience.Pay Range: $142,300.00 - $263,500.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.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.Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
