Description
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.
Position Purpose: Manage populations of patients who meet high risk criteria in order to improve disease state outcomes and improve medication related safety. Ensure safe, effective, and cost-effective medication therapy will be implemented for all patients in their care and monitor care appropriately.
Support quality department to improve HEDIS metrics on projects related to medication adherence and routine health visits
Provide clinical recommendations pertaining to, but not limited to gaps in care, high risk medications, compliance and adherence, drug interactions, therapeutic substitution and generic substitution
Utilize client formulary information and member specific benefits to guide appropriate medication recommendations
Be aware of current and emerging clinical trends and educate clinical team, physicians and other prescribers
Participate in the development of educational materials that may be presented as education intervention programs
Collaborate with physicians and other prescribers by reviewing patients drug profiles to help safeguard against new prescriptions having unintended side effects and by working with prescribers to assure that the drugs prescribed are eligible for coverage; are low cost, high quality products
Outreach to physicians to clarify medication regimens and make recommendations
Conduct research and analysis to identify cost management and process/quality improvement opportunities
Centene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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
