Description
Position Purpose: This position will be accountable for the performance of a portfolio of Medical Management initiatives and the implementation of the Health Equity Cultural Competency Program.
Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
***This candidate must reside in the state of California.***
- Accountable for the performance of a portfolio of initiatives aimed at creating value/ savings in areas of medical management. Responsible for the overall planning, management, and effective implementation and support of initiatives to create value across clinical operations areas such as care management, utilization management, outreach programs, and other services related to both physical and behavioral health.
- Evaluates specialty companies/ vendors, defines business terms during the contracting process, and partners with specialty companies, Corporate departments / resources, and other health plan departments to lead the implementation of new medical management programs with these vendors.
- Oversees/ directly manages a team responsible for project management, performance improvement, and clinical analytics
- Collaborate with all internal and external stakeholders in identifying, developing, and implementing innovative programs and initiatives to improve outcomes.
- Promotes an environment of cultural competence throughout the health plan through identification and implementation of culturally-inclusive best practices and innovations, such as the development of provider trainings to improve cultural awareness and competency within the provider network.
- Partners with community, regional and statewide organizations and stakeholders to identify opportunities to collaborate to improve delivery of culturally competent programs and services.
- Assesses cultural diversity of the provider network to identify resources and gaps, including needs analysis for non-traditional providers (traditional healers, religious and spiritual resources, natural support systems, etc.) and develops recommendations for credentialing and network development activities. Monitors and evaluates provider practices through KPIs within health equity dashboards to assess and improve the cultural competence of delivered services by addressing care gaps and aligning interventions to resolve.
- Responsible for implementation of population specific activities (such as training, awareness through the media, and partnering with various external equity stakeholders), including cultural treatment teams and other cultural community support system activities. Identify trends in specific populations and recommend interventions. Identifies population health disparities and creates outreach, community activities, and innovative programming to engage in services.
- Creates and implements a comprehensive, outcomes-based Cultural Competency Plan that is aligned with CLAS standards and national and regional priorities/initiatives. The plan also incorporates data-driven assessments of culturally competent performance, and defines a strategy for the continual provision, monitoring and improvement of culturally competent performance.
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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
