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Manager, Service Coordination

McAllen, Texas Apply Now Job ID 1134853 Category Health Insurance Operations Organization Superior HealthPlan Schedule Full-time
Description:
Position Purpose: Oversee the infrastructure that coordinates necessary resources for members. This infrastructure may include adequate clinical, behavioral, acute/chronic, and social care services.

  • Coordinate and communicate on access issues, assessments, internal Managed Care Organization (MCO) protocols and other key information with external stakeholders.
  • Develop and implement appropriate policies and procedures; ensure staff are able to facilitate member and provider needs through entire case management cycle.
  • Partner with internal staff on key initiatives and outreach for members as needed
  • Create effective organizational structure, roles and jobs.
  • Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives.
  • Compile and review multiple reports on work function activities for statistical purposes, financial tracking purposes and for process improvement to identify trends, assist in financial forecasting, and make recommendations to management. Monitor and report on achievement of committed action plans.
  • Ensure appropriate representation of MCO at meetings with key internal and external stakeholders.
  • Qualifications:

    Education/Experience: Bachelor’s degree in Nursing, Social Work, Health Care Administration, related field or equivalent experience. 5+ years of nursing, social work, healthcare administration, or patient/community advocacy experience. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff. Other state specific requirements may apply.

    License/Certification: RN license preferred.

    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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