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Director, Care Manager Transformation

Charlotte, North Carolina Apply Now Job ID 1145598 Category Health Insurance Operations Organization Carolina Complete Health Schedule Full-time
Position Purpose: Develop, recommend, and implement care management transformation interventions. Collaborate with provider practices and DHHS to facilitate redesign efforts, support care teams, introduce population health management and support achievement towards improved financial, process and clinical outcomes.

Develop and execute set of intervention work plans to drive provider practices to improve quality measures and transformation

Assist with daily, weekly, monthly reporting requirements
Develop and implement workflow design and redesign for documentation and AMH/CIN/LHD collaboration and data strategy
Actively participate in cross functional teams to conduct work and resolve plan issues
Develop and implement changes to root causes of provider underperformance for quality, compliance and member outcomes. Work with provider network partner to communicate and address these root causes.
Oversee liaison staff that will work collaboratively with provider network partner and providers
Education/Experience: Bachelor’s degree in a Healthcare, or related, field (healthcare admin, public health, etc). Health insurance, care management experience, coding experience, MHA or MPH preferred. 7+ years of provider/medical ops experience in healthcare or managed care preferred. 0-3 years of supervisory/management experience required.

License/Certification: Current, valid and unrestricted LPN, LVN, Social work or RN, CPHQ

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.
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