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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

• Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines
• Monitors and tracks UM BH resources to ensure adherence to performance, quality, and efficiency standards
• Works with BH utilization management team to resolve complex BH care member issues related to BH
• Maintains knowledge of regulations, accreditation standards, and industry best practices related to BH utilization management
• Works with BH utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
• Educates and provides resources for BH utilization management team on key initiatives and to facilitate on-going communication between BH utilization management team, members, and providers
• Works with the BH senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
• Evaluates BH utilization management team performance and provides feedback regarding performance, goals, and career milestones
• Provides coaching and guidance to the BH utilization management team for optimal performance management and provides counseling and corrective action when required
• Assists with onboarding, hiring, and training BH utilization management team members
• Attends company meetings in absence of people leader
• Acts as primary contact for escalated calls/issues that require research or special handling
• Leads and manage others in a matrixed/cross functional environment
• Leads and champions change within scope of responsibility
• Presents information and responds to questions from peers, leaders and internal/external customers
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 4+ years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Knowledge of BH utilization management principles preferred.
Prior supervisory experience preferred preferred.
Understanding of medical necessity criteria for a broad range of BH services preferred.

License/Certification:

• LCSW- License Clinical Social Worker required or
• LMHC-Licensed Mental Health Counselor required or
• LPC-Licensed Professional Counselor required or
• Licensed Marital and Family Therapist (LMFT) required or
• Licensed Mental Health Professional (LMHP) required or
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

***NOTE: This is a hybrid-remote role with 50-75% local travel for (1) home visits focusing on Physically Disabled/Elderly waiver services as well as (2) visits to assist members residing in Supportive Living facilities (SLF) occasionally. Preference will be given to applicants with waiver, case management, advocacy or home visits/community travel experience who reside in the following northwestern Illinois Counties: Jo Daviess, Carroll, Whiteside, Rock Island, Mercer, Henry, Bureau (mainly Quad City area). Rock Island County, IL highly preferred.

• Department: LTSS Case Management - Community

• Caseload: Physical Disability & Aging Waiver Members

• Schedule: Monday through Friday, 8-5 pm CT with hour lunch ***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

Remote Role: Requires 2 - 4 years experience supporting Clinical NICU Teams.

Position Purpose: Works with care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.

• Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling, and ongoing education for both the member and provider throughout care/service
• Provides experienced support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
• May apply in-depth knowledge of assigned health plan(s) activities and resources
• Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols
• Applies in-depth knowledge of care management support activities including care plans and community resources
• Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
• Works with care management team on escalating requests and inquiries to management
• Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
• May support training of new hires
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Perform day to day duties of assuring that providers (individual, group, ancillary, etc.) are set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution as it relates to provider set up.

• Provide support to the external provider representative to resolve provider data issues

• Research and effectively respond to provider related issues

• Submit provider data entries to resolve provider-related demographic information changes

• Initiate and process provider add, change and termination forms

• Create and maintain spreadsheets used to produce provider directories for multiple products.

• Track, update and audit provider data

• Identify adds, deletes and updates to key provider groups and model contracts

• Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment

• Provide assistance to providers with website registration

• Facilitate provider education via webinar

• Work with other departments on cross functional tasks and projects

• Facilitate new provider orientations

• Facilitate provider trainings

• Act as liaison for small PCP groups (as designated by departmental leadership).

• Coaches new hires and less experienced Internal Reps.

• Completes special projects as assigned

• Performs other duties as assigned

• Complies with all policies and standards

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60682, 60104, 60163, 60402, 60153, 60155, 60513, 60155, 60513, 60631, 60634, 60639, 60644, 60651, 60656, 60701, 60706, 60707, 60804, 60525, 60130, 60131, 60162, 60141, 60526, 60534, 60160, 60161, 60164, 60165, 60546, 60301, 60302, 60304, 60068, 60305, 60171, 60176, 60154, 60558 (Nearby cities/towns: Chicago, Bellwood, Berkeley, Berwyn, Maywood, Broadview, Brookfield, Summit Argo, Harwood Heights, Elmwood Park, Cicero, La Grange, Forest Park, Franklin Park, Hillside, Hines, La Grange Park, Lyons, Melrose Park, Stone Park, Riverside, Oak Park, Park Ridge, River Forest, River Grove, Schiller Park, Westchester, and Western Springs).

Additional Details:

• Department: Long Term Support Services, Case Management
• Caseload: Physical Disability & Aging Waiver Members
• Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote — U.S. nationwide.

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.

Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and act as a lead/resource for other Data Analysts. This Internal Audit Claims role supports claims audit execution through sampling, executive reporting, QA/reconciliation, Power BI/dashboard support, automation validation, bot/AI enablement, and repeatable management-ready analytics.

• Support Internal Audit Claims analytics, including recurring claims audit sampling, executive reporting, AuditWell support, Power BI dashboard support, error/CAP trend analysis, and repeatable management-ready analytics.

• Extract, transform, reconcile, and validate large healthcare claims datasets across enterprise data sources, including claims, provider, member, financial, operational, and audit-related data.

• Perform structured QA, reconciliation, tie-outs, and validation of claims audit reporting, sampling outputs, dashboards, automation results, and executive-ready deliverables.

• Develop and maintain recurring reports, dashboards, and analytical deliverables using SQL, Power BI, Excel, Snowflake, Teradata, MS SQL Server, or similar data warehouse / business intelligence tools.

• Partner with audit, data analytics, IT, and business stakeholders to translate reporting, sampling, and automation needs into repeatable data processes, documentation, and validated outputs.

• Support automation, bot, AI, and process-improvement initiatives through requirements translation, testing support, output validation, documentation, and controlled implementation.

• Identify data issues, trends, process gaps, and reporting improvement opportunities; communicate findings clearly to management and support timely resolution.

• Assist with training and mentoring other Data Analysts.

Required Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Preferred Skills:

• Advanced SQL experience, including extracting, joining, reconciling, and validating large datasets from enterprise data warehouse environments.

• Power BI experience, including Power BI Desktop, Power BI Service, workspace/report maintenance, refresh validation, access/security coordination, and service-account-based reporting processes.

• Healthcare claims analytics experience strongly preferred, especially experience with post-pay claims data, claims processing systems, audit/compliance reporting, or quality review processes.

• Experience with Snowflake, Teradata, MS SQL Server, EDW, or similar enterprise data platforms.

• Strong data quality and reconciliation mindset, including structured tie-outs, report validation, issue documentation, and validation of automated reporting outputs.

• Experience supporting automation, ETL, API-based processes, C#, .NET, Python, Alteryx, or similar workflow/process-improvement efforts preferred.

• Ability to translate technical findings into concise, management-ready explanations for audit leadership, business stakeholders, and cross-functional partners.

​

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and post-pay experience highly preferred.

Position Purpose:
Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professional judgment in assessing complex clinical information, validating diagnosis code assignments, and identifying discrepancies such as coding errors or upcoding. Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting regulatory requirements, and making authoritative decisions to ensure compliance with all applicable laws, payer contracts, and organizational policies.

• Independently conducts comprehensive MS-DRG and APR-DRG coding and clinical validation reviews, exercising professional judgment to verify ICD-10-CM/PCS assignments, validate clinical diagnoses, identify discrepancies, and apply inpatient reimbursement rules without direct supervision.

• Collaborates with the Medical Director on complex cases, providing expert recommendations and influencing review outcomes to ensure clinical accuracy and compliance.

• Leads the evaluation of complex cases and proactively identifies opportunities to develop medical policy in the absence of established guidelines, demonstrating discretion and authority in decision-making.

• Applies advanced knowledge of coding guidelines and clinical policies throughout the review process, making autonomous determinations regarding coding accuracy and regulatory compliance.

• Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, approved Centene policies, and adopted clinical guidelines, ensuring recommendations reflect professional expertise.

• Evaluates claims and medical records for compliance with state and federal regulations, payer contracts, and company policies, exercising independent judgment in interpreting requirements and resolving ambiguities.

• Consistently meets or exceeds established quality and productivity standards while managing priorities and workflow autonomously.

• Contributes to strategic initiatives by assisting in the development of audit concepts, identifying new audit opportunities, and selecting claims for review, demonstrating leadership in shaping audit methodologies.
• Performs other duties as assigned.

• Complies with all policies and standards.

Education/Experience:

Associate's Degree in Health Information Management, Nursing, or related field required

4+ years experience of performing MS-DRG and APR-DRG coding required
2+ years experience of performing DRG reviews for a Payment Integrity vendor or Payer required
2+ years experience of using DRG encoder/grouper experience (TruCode/TruBridge, 3M, Optum Encoder, Webstrat, PSI, or similar) required
1+ years experience of inpatient hospital documentation improvement preferred

Licenses/Certifications:
RHIT - Registered Health Information Technician required or
RHIA - Registered Health Information Administrator required or:
CCS-Certified Coding Specialist required or:
Certified International Credit Professional (CICP) required or:
CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State Licensure and/or Compact State Licensure Registered Nurse or Higher (in combination with a coding credential) preferred

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

Position Purpose: Responsible for multiple accounting functions including: paying claims, accounts payable, accounts receivable, maintaining daily & monthly bank accounts & cash balances, reconciling General Ledger accounts; and analyze financial data.

• Maintain cash balances daily & reconcile bank accounts monthly
• Reconcile general ledger accounts
• Analyze financial data
• Provide audit assistance on financial, regulatory, and health plan audits
• Manage the accounts payable process including check generation
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor’s degree in accounting or equivalent experience. 2+ years of accounting experience.

License/Certification: CPA preferred.

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

Position Purpose: Responsible for multiple accounting functions including: paying claims, accounts payable, accounts receivable, maintaining daily & monthly bank accounts & cash balances, reconciling General Ledger accounts; and analyze financial data.

• Maintain cash balances daily & reconcile bank accounts monthly
• Reconcile general ledger accounts
• Analyze financial data
• Provide audit assistance on financial, regulatory, and health plan audits
• Manage the accounts payable process including check generation
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor’s degree in accounting or equivalent experience. 2+ years of accounting experience.

License/Certification: CPA preferred.

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

Position Purpose: Responsible for multiple accounting functions including: paying claims, accounts payable, accounts receivable, maintaining daily & monthly bank accounts & cash balances, reconciling General Ledger accounts; and analyze financial data.

• Maintain cash balances daily & reconcile bank accounts monthly
• Reconcile general ledger accounts
• Analyze financial data
• Provide audit assistance on financial, regulatory, and health plan audits
• Manage the accounts payable process including check generation
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor’s degree in accounting or equivalent experience. 2+ years of accounting experience.

License/Certification: CPA preferred.

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

Position Purpose: Responsible for multiple accounting functions including: paying claims, accounts payable, accounts receivable, maintaining daily & monthly bank accounts & cash balances, reconciling General Ledger accounts; and analyze financial data.

• Maintain cash balances daily & reconcile bank accounts monthly
• Reconcile general ledger accounts
• Analyze financial data
• Provide audit assistance on financial, regulatory, and health plan audits
• Manage the accounts payable process including check generation
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor’s degree in accounting or equivalent experience. 2+ years of accounting experience.

License/Certification: CPA preferred.

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

Position Purpose: Responsible for multiple accounting functions including: paying claims, accounts payable, accounts receivable, maintaining daily & monthly bank accounts & cash balances, reconciling General Ledger accounts; and analyze financial data.

• Maintain cash balances daily & reconcile bank accounts monthly
• Reconcile general ledger accounts
• Analyze financial data
• Provide audit assistance on financial, regulatory, and health plan audits
• Manage the accounts payable process including check generation
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor’s degree in accounting or equivalent experience. 2+ years of accounting experience.

License/Certification: CPA preferred.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

*Note: This is a fully remote role. 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.

Position Purpose: Plan, organize, monitor, and oversee complex projects for clinical vendor program implementation utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment and closure.

• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.

• Assist with establishment and maintenance of corporate project management methodology and other department procedures.

• Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

• Provide leadership and effectively communicate project status to all stakeholders, may include written executive summaries.

• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.

• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.

• Provide functional and technical knowledge across multiple business and technical areas.

• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.

Highly Preferred Skills:

• Demonstrated experience managing clinical program initiatives, vendor implementations, or related implementation efforts in a complex, cross-functional environment.

• Comfortable leading cross-functional meetings.

• Working knowledge of Smartsheet and proficiency in MS Office Suite.

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

This position serves the NH Health Families Medicaid population. NH RN Licensure is required. Experience in both Physical Health and Behavioral Health is highly preferred.

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

• Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome
• Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
• Identifies problems/barriers to care and provide appropriate care management interventions
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services
• Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
• Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate
• Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience.

License/Certification:

• RN - Registered Nurse - State Licensure and/or Compact State Licensure required
• This position is for New Hampshire

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

• Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome
• Develops or contributes to the development of a personalized care plan/service ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care
• Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely manner
• May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member’s needs and collaborate with providers or resources, as appropriate
• May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits
• Other duties or responsibilities as assigned by people leader to meet the member and/or business needs
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a Bachelor’s degree and 2 – 4 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

License/Certification:

• Current state’s clinical license preferred

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

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a High School diploma or GED.
Requires 1 – 2 years of related experience

License/Certification:

• For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required

Preferred Qualifications:

• This is a field-based role supporting members with behavioral health and developmental disabilities needs. Candidates should have strong experience working with Behavioral Health and/or Developmental Disabilities (BH/DD) populations. Applicants must reside in Washington, Benton, or Madison County, Arkansas.

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

This position is Tuesday-Saturday or Wednesday - Sunday 8am to 5pm with holiday rotation.

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

• Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate

• Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria

• Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning

• Analyzes BH member data to improve quality and appropriate utilization of services

• Provides education to providers members and their families regrading BH utilization process

• Interacts with BH healthcare providers as appropriate to discuss level of care and/or services

• Engages with medical directors and leadership to improve the quality and efficiency of care

• Formulates and presents cases in staffing and integrated rounds

• Performs other duties as assigned.

• Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master’s degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

• LCSW- License Clinical Social Worker required or

• LMHC-Licensed Mental Health Counselor required or

• LPC-Licensed Professional Counselor required or

• Licensed Marital and Family Therapist (LMFT) required or

• Licensed Mental Health Professional (LMHP) required or

• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

****NOTE: This hybrid-remote position (50% local travel) supports members enrolled in Aging and Physical Disabilities Waiver programs. Responsibilities include conducting in-home assessments, developing and coordinating care plans, and connecting members with healthcare providers, community resources, and durable medical equipment (DME) services. Preference will be given to applicants who reside within 30 minutes of the Lake Zurich/Barrington, IL area in either Lake or Cook county, IL with past case management, advocacy or home visits/community travel experience.

• Department: LTSS Case Management

• Caseload: Physical Disability & Aging Waiver Members

• Schedule: Monday through Friday, 8-4:30 pm CT with 30 minute lunch ****

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

****NOTE: This hybrid-remote position (50% local travel) supports members enrolled in Aging and Physical Disabilities Waiver programs. Responsibilities include conducting in-home assessments, developing and coordinating care plans, and connecting members with healthcare providers, community resources, and durable medical equipment (DME) services. Preference will be given to applicants who reside within 30 minutes of the Lake Zurich/Barrington, IL area in either Lake or Cook county, IL with past case management, advocacy or home visits/community travel experience.

• Department: LTSS Case Management

• Caseload: Physical Disability & Aging Waiver Members

• Schedule: Monday through Friday, 8-4:30 pm CT with 30 minute lunch ****

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

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

Position Purpose: Leads the Identity and Access Management systems and solutions. Performs review of system, user, and administrative roles and accounts and to understand access levels for enterprise applications and platforms. Designs, builds, tests, and maintains scalable and stable off-the-shelf software applications or custom builds technology software solutions to meet technical business identity access needs. Leads cross functional teams through the entire implementation process.

• Enforces policies and procedures related to identity lifecycle management, and supporting resources using IAM technical best practices

• Analyzes, designs, develops, implements, and supports identity related areas of software applications and identity governance

• Reviews documentation of IAM related technical requirements, designs, infrastructure, and support processes

• Liaises with other teams in information security risk management infrastructure, architecture management, and business functions to implement end to end IAM solutions

• Leads the development of overall IAM technical strategies, designs, standards and procedures which support business strategies

• Performs the coding, configuring, testing and documentation of developments in the IAM landscape

• Troubleshoots and solves a wide variety of security focused IAM issues

• Ensures compliance with corporate policies and procedures, ethical practices, and regulatory guidelines

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: A Bachelor's degree in a quantitative or business field (e.g., statistics, mathematics, engineering, computer science) and requires 5 – 7 years of related experience.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Technical Skills:

• One or more of the following skills are desired.

• Experience with Other: Active Directory, Okta, Ping

• Knowledge of Cloud Computing Security

• Knowledge of Other: Identity as a Service (IDaaS) solutions

Soft Skills:

• Intermediate - Seeks to acquire knowledge in area of specialty

• Intermediate - Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions

• Intermediate - Ability to work independently

• Intermediate - Demonstrated analytical skills

• Intermediate - Demonstrated project management skills

• Intermediate - Demonstrates a high level of accuracy, even under pressure

• Intermediate - Demonstrates excellent judgment and decision making skills

• Intermediate - Ability to communicate and make recommendations to upper management

• Intermediate - Ability to drive multiple projects to successful completion

• Intermediate - Possesses technical aptitude

License/Certification:

• Certified Identity and Access Manager (CIAM) within 120 Days required

• Certified Identity and Security Technologist (CIST) preferred

• Certified Access Management Specialist (CAMS) preferred

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

Remote Role: Level III & IV NICU Bedside Experience preferred.

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to NICU members. Supervises day-to-day activities of utilization management team.

• Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
• Collaborates with utilization management team to resolve complex care member issues
• Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
• Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
• Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
• Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
• Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
• Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
• Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
• Assists with onboarding, hiring, and training utilization management team members
• Leads and champions change within scope of responsibility
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.
Knowledge of utilization management principles preferred.

License/Certification:

• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

Position Purpose: Develop, analyze, and execute accounting and finance functions. Prepare managerial reports, financial reports, and general ledger.

• Prepare and analyze journal entries, income statement, balance sheet, profit and loss statement, and other financial reports on a regular basis
• Report and advise on organization’s financial status
• Develop analytical financial tools for critical at risk balance sheet accounts
• Develop, implement, modify, and document accounting systems
• Adapt accounting and recordkeeping functions to current computerized accounting systems technology
• Assist with the treasury functions by overseeing weekly activity and reporting this activity to management
• Prepare and maintain claims liability lag reports
• Reconcile and review claims system reports and claims liability reports to checks paid and other empirical data
• May be involved with due diligence, integration activities with acquired companies, technical accounting research, and other business issues
• Conduct special studies, develop, or recommend enhancements to accounting methods and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Develop, analyze, and execute accounting and finance functions. Prepare managerial reports, financial reports, and general ledger.

• Prepare and analyze journal entries, income statement, balance sheet, profit and loss statement, and other financial reports on a regular basis
• Report and advise on organization’s financial status
• Develop analytical financial tools for critical at risk balance sheet accounts
• Develop, implement, modify, and document accounting systems
• Adapt accounting and recordkeeping functions to current computerized accounting systems technology
• Assist with the treasury functions by overseeing weekly activity and reporting this activity to management
• Prepare and maintain claims liability lag reports
• Reconcile and review claims system reports and claims liability reports to checks paid and other empirical data
• May be involved with due diligence, integration activities with acquired companies, technical accounting research, and other business issues
• Conduct special studies, develop, or recommend enhancements to accounting methods and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Develop, analyze, and execute accounting and finance functions. Prepare managerial reports, financial reports, and general ledger.

• Prepare and analyze journal entries, income statement, balance sheet, profit and loss statement, and other financial reports on a regular basis
• Report and advise on organization’s financial status
• Develop analytical financial tools for critical at risk balance sheet accounts
• Develop, implement, modify, and document accounting systems
• Adapt accounting and recordkeeping functions to current computerized accounting systems technology
• Assist with the treasury functions by overseeing weekly activity and reporting this activity to management
• Prepare and maintain claims liability lag reports
• Reconcile and review claims system reports and claims liability reports to checks paid and other empirical data
• May be involved with due diligence, integration activities with acquired companies, technical accounting research, and other business issues
• Conduct special studies, develop, or recommend enhancements to accounting methods and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Develop, analyze, and execute accounting and finance functions. Prepare managerial reports, financial reports, and general ledger.

• Prepare and analyze journal entries, income statement, balance sheet, profit and loss statement, and other financial reports on a regular basis
• Report and advise on organization’s financial status
• Develop analytical financial tools for critical at risk balance sheet accounts
• Develop, implement, modify, and document accounting systems
• Adapt accounting and recordkeeping functions to current computerized accounting systems technology
• Assist with the treasury functions by overseeing weekly activity and reporting this activity to management
• Prepare and maintain claims liability lag reports
• Reconcile and review claims system reports and claims liability reports to checks paid and other empirical data
• May be involved with due diligence, integration activities with acquired companies, technical accounting research, and other business issues
• Conduct special studies, develop, or recommend enhancements to accounting methods and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Develop, analyze, and execute accounting and finance functions. Prepare managerial reports, financial reports, and general ledger.

• Prepare and analyze journal entries, income statement, balance sheet, profit and loss statement, and other financial reports on a regular basis
• Report and advise on organization’s financial status
• Develop analytical financial tools for critical at risk balance sheet accounts
• Develop, implement, modify, and document accounting systems
• Adapt accounting and recordkeeping functions to current computerized accounting systems technology
• Assist with the treasury functions by overseeing weekly activity and reporting this activity to management
• Prepare and maintain claims liability lag reports
• Reconcile and review claims system reports and claims liability reports to checks paid and other empirical data
• May be involved with due diligence, integration activities with acquired companies, technical accounting research, and other business issues
• Conduct special studies, develop, or recommend enhancements to accounting methods and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Program/Team Supported: Oklahoma Complete Health – Behavioral Health Utilization Management

Training Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. for the first 6 weeks

Work Schedule: Tuesday–Saturday, 8:00 a.m.–5:00 p.m., with Sunday and Monday off each week

Holiday Coverage: Required on a rotating schedule

Location Requirement: Must reside in Oklahoma

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

• Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
• Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
• Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
• Analyzes BH member data to improve quality and appropriate utilization of services
• Provides education to providers members and their families regrading BH utilization process
• Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
• Engages with medical directors and leadership to improve the quality and efficiency of care
• Formulates and presents cases in staffing and integrated rounds
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.
License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master’s degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

• LCSW- License Clinical Social Worker required or
• LMHC-Licensed Mental Health Counselor required or
• LPC-Licensed Professional Counselor required or
• Licensed Marital and Family Therapist (LMFT) required or
• Licensed Mental Health Professional (LMHP) required or
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

Must reside in the state of Kansas.

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a High School diploma or GED.
Requires 1 – 2 years of related experience

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

****NOTE: This is a fully remote role for US based applicants with independent clinical licensure. Reviews will focus on the following settings: residential treatment center, inpatient psychiatric admissions, detox, crisis stabilization unit, PHP, and community based services. Preference will be given to applicants who (1) reside ideally in Mississippi, Louisiana, Arkansas, Texas, or Tennessee, (2) have experience in utilization management/review and (3) in behavioral health settings. (4) Experience with Mississippi market, managed care, Mental Health Residential Services for children, or Juvenile Sex Offender Program is preferred.

Additional Details:

• Department: Mississippi Magnolia Health / Behavioral Health Utilization Management

• Schedule: 8-5 PM Central (Non-negotiable) with potential for occasional weekends and holidays ****

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

• Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
• Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
• Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
• Analyzes BH member data to improve quality and appropriate utilization of services
• Provides education to providers members and their families regrading BH utilization process
• Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
• Engages with medical directors and leadership to improve the quality and efficiency of care
• Formulates and presents cases in staffing and integrated rounds
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master’s degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

• LCSW- License Clinical Social Worker required or
• LMHC-Licensed Mental Health Counselor required or
• LPC-Licensed Professional Counselor required or
• Licensed Marital and Family Therapist (LMFT) required or
• Licensed Mental Health Professional (LMHP) required or
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

****NOTE: This is a fully remote role for US based applicants with independent clinical licensure. Reviews will focus on the following settings: residential treatment center, inpatient psychiatric admissions, detox, crisis stabilization unit, PHP, and community based services. Preference will be given to applicants who (1) reside ideally in Mississippi, Louisiana, Arkansas, Texas, or Tennessee, (2) have experience in utilization management/review and (3) in behavioral health settings. (4) Experience with Mississippi market, managed care, Mental Health Residential Services for children, or Juvenile Sex Offender Program is preferred.

Additional Details:

• Department: Mississippi Magnolia Health / Behavioral Health Utilization Management

• Schedule: 8-5 PM Central (Non-negotiable) with potential for occasional weekends and holidays ****

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

• Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
• Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
• Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
• Analyzes BH member data to improve quality and appropriate utilization of services
• Provides education to providers members and their families regrading BH utilization process
• Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
• Engages with medical directors and leadership to improve the quality and efficiency of care
• Formulates and presents cases in staffing and integrated rounds
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master’s degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

• LCSW- License Clinical Social Worker required or
• LMHC-Licensed Mental Health Counselor required or
• LPC-Licensed Professional Counselor required or
• Licensed Marital and Family Therapist (LMFT) required or
• Licensed Mental Health Professional (LMHP) required or
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

****NOTE: This is a fully remote role for US based applicants with independent clinical licensure. Reviews will focus on the following settings: residential treatment center, inpatient psychiatric admissions, detox, crisis stabilization unit, PHP, and community based services. Preference will be given to applicants who (1) reside ideally in Mississippi, Louisiana, Arkansas, Texas, or Tennessee, (2) have experience in utilization management/review and (3) in behavioral health settings. (4) Experience with Mississippi market, managed care, Mental Health Residential Services for children, or Juvenile Sex Offender Program is preferred.

Additional Details:

• Department: Mississippi Magnolia Health / Behavioral Health Utilization Management

• Schedule: 8-5 PM Central (Non-negotiable) with potential for occasional weekends and holidays ****

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

• Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
• Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
• Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
• Analyzes BH member data to improve quality and appropriate utilization of services
• Provides education to providers members and their families regrading BH utilization process
• Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
• Engages with medical directors and leadership to improve the quality and efficiency of care
• Formulates and presents cases in staffing and integrated rounds
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master’s degree for behavioral health clinicians required.
Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.
Knowledge of mental health and substance abuse utilization review process preferred.
Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

• LCSW- License Clinical Social Worker required or
• LMHC-Licensed Mental Health Counselor required or
• LPC-Licensed Professional Counselor required or
• Licensed Marital and Family Therapist (LMFT) required or
• Licensed Mental Health Professional (LMHP) required or
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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

Remote Role: Requires 2 - 4 years experience supporting Clinical NICU Teams.

Position Purpose: Works with care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.

• Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling, and ongoing education for both the member and provider throughout care/service
• Provides experienced support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
• May apply in-depth knowledge of assigned health plan(s) activities and resources
• Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols
• Applies in-depth knowledge of care management support activities including care plans and community resources
• Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
• Works with care management team on escalating requests and inquiries to management
• Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
• May support training of new hires
• Performs other duties as assigned
• Complies with all policies and standards

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

Remote Role: Requires 2 - 4 years experience supporting Clinical NICU Teams.

Position Purpose: Works with care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.

• Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling, and ongoing education for both the member and provider throughout care/service
• Provides experienced support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
• May apply in-depth knowledge of assigned health plan(s) activities and resources
• Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols
• Applies in-depth knowledge of care management support activities including care plans and community resources
• Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
• Works with care management team on escalating requests and inquiries to management
• Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
• May support training of new hires
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Oversee the maintenance of accurate financial records, including preparing monthly financial reports and various analytical reports. Oversee routine financial analysis; complete complex financial analysis. Develop business knowledge in financial reporting, risk management, contracting, benefit analysis, and other financial functions.

• Ensure that timely and accurate reports are generated
• Produce and analyze complex financial and statistical reports
• Generate and review ad-hoc reports related to quality, cost and effectiveness of healthcare services
• Gather and prepare analysis based on information from various sources and financial reports
• Provide financial and business analysis as required
• Determine appropriate actions and present to upper management
• Develop a thorough understanding of healthcare practices and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Oversee the maintenance of accurate financial records, including preparing monthly financial reports and various analytical reports. Oversee routine financial analysis; complete complex financial analysis. Develop business knowledge in financial reporting, risk management, contracting, benefit analysis, and other financial functions.

• Ensure that timely and accurate reports are generated
• Produce and analyze complex financial and statistical reports
• Generate and review ad-hoc reports related to quality, cost and effectiveness of healthcare services
• Gather and prepare analysis based on information from various sources and financial reports
• Provide financial and business analysis as required
• Determine appropriate actions and present to upper management
• Develop a thorough understanding of healthcare practices and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Oversee the maintenance of accurate financial records, including preparing monthly financial reports and various analytical reports. Oversee routine financial analysis; complete complex financial analysis. Develop business knowledge in financial reporting, risk management, contracting, benefit analysis, and other financial functions.

• Ensure that timely and accurate reports are generated
• Produce and analyze complex financial and statistical reports
• Generate and review ad-hoc reports related to quality, cost and effectiveness of healthcare services
• Gather and prepare analysis based on information from various sources and financial reports
• Provide financial and business analysis as required
• Determine appropriate actions and present to upper management
• Develop a thorough understanding of healthcare practices and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Oversee the maintenance of accurate financial records, including preparing monthly financial reports and various analytical reports. Oversee routine financial analysis; complete complex financial analysis. Develop business knowledge in financial reporting, risk management, contracting, benefit analysis, and other financial functions.

• Ensure that timely and accurate reports are generated
• Produce and analyze complex financial and statistical reports
• Generate and review ad-hoc reports related to quality, cost and effectiveness of healthcare services
• Gather and prepare analysis based on information from various sources and financial reports
• Provide financial and business analysis as required
• Determine appropriate actions and present to upper management
• Develop a thorough understanding of healthcare practices and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

Position Purpose: Oversee the maintenance of accurate financial records, including preparing monthly financial reports and various analytical reports. Oversee routine financial analysis; complete complex financial analysis. Develop business knowledge in financial reporting, risk management, contracting, benefit analysis, and other financial functions.

• Ensure that timely and accurate reports are generated
• Produce and analyze complex financial and statistical reports
• Generate and review ad-hoc reports related to quality, cost and effectiveness of healthcare services
• Gather and prepare analysis based on information from various sources and financial reports
• Provide financial and business analysis as required
• Determine appropriate actions and present to upper management
• Develop a thorough understanding of healthcare practices and procedures
• Performs other duties as assigned
• Complies with all policies and standards

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: The Pharmacy Quality Performance Manager will partner with health plans to drive pharmacy performance with an emphasis on pharmacy quality measures. Cross discipline interfacing across internal teams and external provider group partners to accelerate pharmacy quality.

• Provide expertise in enterprise pharmacy quality initiatives

• Subject matter expert on pharmacy quality measures across LOBs (Medicare, Medicaid, Marketplace)

• Provide clinical and quality expertise to health plans and provider partners

• Develop and present performance reviews in tandem with provider facing teams to address pharmacy chapter quality performance across: members, providers, provider groups, H-Contract and States

• Strategize and coordinate between market and enterprise pharmacy chapter measure initiatives to ensure complimentary efforts

• Identify areas of opportunity for internal teams’ and external provider partners’ operations to accelerate pharmacy measure performance

• Facilitate communication, understanding and training around enterprise pharmacy quality initiatives to internal provider facing teams to extend the reach of quality performance impact

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy required
3+ years of retail or hospital pharmacy experience or 1+ years of managed care pharmacy experience required
Clinical pharmacy experience in a managed healthcare environment preferred

Centene Pharmacy Services: 3+ years managed care pharmacy or pharmacy benefit management experience preferred

PHARM-R - Registered Pharmacist Current state with no restrictions Upon Hire required:

Location Requirement:
Candidates must reside in the Brooklyn, Jamaica, or Queens areas.

Travel Requirements:
This is a remote role with travel of 50% or more to provider offices and community pharmacies. Candidates must be able to maintain a regular travel schedule within the assigned region.

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

Position Purpose:

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
• Supports effective implementation of performance improvement initiatives for capitated providers.
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
• Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
• Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
• Participates in provider network development and new market expansion as appropriate.
• Assists in the development and implementation of physician education with respect to clinical issues and policies.
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
• Develops alliances with the provider community through the development and implementation of the medical management programs.
• As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
• Represents the business unit at appropriate state committees and other ad hoc committees.
• May be required to work weekends and holidays in support of business operations, as needed.
• Complies with all policies and standards

Education/Experience:

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

License/Certifications:

• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• (Certification in Psychiatry specialty Is required.)
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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

Position Purpose:

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
• Supports effective implementation of performance improvement initiatives for capitated providers.
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
• Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
• Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
• Participates in provider network development and new market expansion as appropriate.
• Assists in the development and implementation of physician education with respect to clinical issues and policies.
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
• Develops alliances with the provider community through the development and implementation of the medical management programs.
• As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
• Represents the business unit at appropriate state committees and other ad hoc committees.
• May be required to work weekends and holidays in support of business operations, as needed.
• Complies with all policies and standards

Education/Experience:

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

License/Certifications:

• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• (Certification in Psychiatry specialty Is required.)
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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

Position Purpose:

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
• Supports effective implementation of performance improvement initiatives for capitated providers.
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
• Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
• Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
• Participates in provider network development and new market expansion as appropriate.
• Assists in the development and implementation of physician education with respect to clinical issues and policies.
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
• Develops alliances with the provider community through the development and implementation of the medical management programs.
• As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
• Represents the business unit at appropriate state committees and other ad hoc committees.
• May be required to work weekends and holidays in support of business operations, as needed.
• Complies with all policies and standards

Education/Experience:

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

License/Certifications:

• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• (Certification in Psychiatry specialty Is required.)
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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

Position Purpose:

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
• Supports effective implementation of performance improvement initiatives for capitated providers.
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
• Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
• Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
• Participates in provider network development and new market expansion as appropriate.
• Assists in the development and implementation of physician education with respect to clinical issues and policies.
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
• Develops alliances with the provider community through the development and implementation of the medical management programs.
• As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
• Represents the business unit at appropriate state committees and other ad hoc committees.
• May be required to work weekends and holidays in support of business operations, as needed.
• Complies with all policies and standards

Education/Experience:

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

License/Certifications:

• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• (Certification in Psychiatry specialty Is required.)
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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

Position Purpose:

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
• Supports effective implementation of performance improvement initiatives for capitated providers.
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
• Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
• Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
• Participates in provider network development and new market expansion as appropriate.
• Assists in the development and implementation of physician education with respect to clinical issues and policies.
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
• Develops alliances with the provider community through the development and implementation of the medical management programs.
• As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
• Represents the business unit at appropriate state committees and other ad hoc committees.
• May be required to work weekends and holidays in support of business operations, as needed.
• Complies with all policies and standards

Education/Experience:

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

License/Certifications:

• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• (Certification in Psychiatry specialty Is required.)
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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

Position Purpose:

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

• Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
• Supports effective implementation of performance improvement initiatives for capitated providers.
• Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
• Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
• Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.
• Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
• Participates in provider network development and new market expansion as appropriate.
• Assists in the development and implementation of physician education with respect to clinical issues and policies.
• Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
• Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
• Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
• Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
• Develops alliances with the provider community through the development and implementation of the medical management programs.
• As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
• Represents the business unit at appropriate state committees and other ad hoc committees.
• May be required to work weekends and holidays in support of business operations, as needed.
• Complies with all policies and standards

Education/Experience:

• Medical Doctor or Doctor of Osteopathy.
• Utilization Management experience and knowledge of quality accreditation standards preferred.
• Actively practices medicine.
• Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous.
• Experience treating or managing care for a culturally diverse population preferred.

License/Certifications:

• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• (Certification in Psychiatry specialty Is required.)
• Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs.

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

Position Purpose: The Program Manager is responsible for leading assigned Utilization Management (UM) initiatives, governance processes, and program execution across a complex, multi-product, multi-market environment—serving as a trusted partner to UM operations and leadership. This role brings structure, prioritization, critical thinking, and operational discipline to a broad portfolio of initiatives, requests, and performance improvement efforts, spanning program planning, cross-functional execution, intake management, operational readiness, and executive reporting. Operating with a high degree of autonomy, the Program Manager translates ambiguous objectives into executable plans, synthesizes complex information into actionable recommendations, and can advance work with limited guidance—escalating appropriately on high-risk or cross-portfolio decisions—to ensure consistent implementation, visibility, accountability, and performance across UM operations.

Responsibilities:

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

Position Purpose:

Drives the development and execution of strategies to enhance operational efficiency, reduce costs, and enhance customer experience and compliance. This executive role is pivotal in driving continuous improvement and fostering a culture of innovation.

• Focus of the role is to ensure operational performance of the Population Health & Clinical Outcomes Organization (PHCO) through the reporting of key metrics, process improvement, audits, and execution.
• Set and align strategic objectives with the overall business strategy.
• Identify and prioritize key areas for operational improvement and enable the execution of improvement.
• Oversee the Project Management Office for the PHCO organization
• Oversee the implementation of operational excellence initiatives, ensuring successful execution and desired outcomes.
• Oversee the enterprise clinical appeals organization
• Establish and manage a robust clinical operational compliance oversight program to support regulatory adherence.
• Analyze and optimize operational processes using methodologies such as Lean, Six Sigma, and Kaizen.
• Standardize processes to ensure consistency and efficiency.
• Monitor and track key performance indicators (KPIs) to measure the effectiveness of operational initiatives.
• Lead and mentor teams in operational excellence practices.
• Build a high-performing team and promote a culture of continuous improvement.
• Collaborate with cross-functional teams to address operational challenges and opportunities.
• Communicate strategies and initiatives effectively to all stakeholders.
• Analyze operational data to identify trends and areas for improvement.
• Develop and implement reporting systems to track operational performance and present findings to senior management.
• Ensure compliance with Plan, Do, Check, and Adjust processes.
• Track and report on operational excellence measures through regular accountability mechanisms.

Education/Experience:

Bachelor's Degree in business administration, healthcare management, or related field or equivalent experience required.
Master's Degree in a related field preferred.
10+ years healthcare operations experience required.

Six Sigma and deep operational experience preferred
Previous experience managing staff, including hiring, training, managing workload and performance. required.
Large-scale experience within environments regulated by state and federal agencies preferred.

Pay Range: $250,000 - $480,000

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

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.

Work Schedule: This role primarily supports Eastern Time hours.

Position Purpose: Responsible for analytic data needs of the business unit. Handles complex data projects and acts as a lead for other Data Analysts. This role blends technical analytics with strong business partnership, supporting clinical and operational teams through actionable data solutions.

• Provide advanced analytical support for business operations in all or some of the following areas: authorizations, claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.
• Develop reports and deliverables for management.
• Model data using Power BI, MS Excel, Access, SQL, and/or other data warehouse analytical tools.
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.
• Assist with training and mentoring other Data Analysts.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

• Bachelor’s degree in related field or equivalent experience.
• 4+ years of statistical analysis or data analysis experience.
• Power BI experience, including building dashboards and data models from source data, strongly preferred.
• SQL coding experience with the ability to extract and validate data from source systems strongly preferred.
• Healthcare analytics experience, particularly with clinical or authorization related data, strongly preferred.
• Advanced Excel skills, including complex formulas, pivot tables, and data validation, strongly preferred.
• Demonstrated analytical and trend analysis skills with the ability to identify insights, issues, and opportunities for improvement, strongly preferred.
• Experience managing projects or heavy involvement in project implementation.

By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified.

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

Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.

• Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations
• Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
• Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
• Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
• Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ability to travel

Education/Experience: Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience. 7+ years of combined contracting, network development or provider relations experience. Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements. Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff. License/Certification: Valid driver's license.

Applicants must be in the state of Pennsylvania to be considered for this role. This is a remote position that requires occasional travel across the state of Pennsylvania for internal and provider-facing meetings.

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

Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.

• Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations
• Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
• Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
• Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
• Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ability to travel

Education/Experience: Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience. 7+ years of combined contracting, network development or provider relations experience. Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements. Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff. License/Certification: Valid driver's license.

Applicants must be in the state of Pennsylvania to be considered for this role. This is a remote position that requires occasional travel across the state of Pennsylvania for internal and provider-facing meetings.

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

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a High School diploma or GED.
Requires 1 – 2 years of related experience

License/Certification:

• For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required

Preferred Qualifications:

• This is a field-based role supporting members with behavioral health and developmental disabilities needs. Candidates should have strong experience working with both Behavioral Health and Developmental Disabilities (BH/DD) populations. Applicants must reside in Pope, Johnson, or Yell County, Arkansas.

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

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a Bachelor's degree and 2 – 4 years of related experience.
; or
Individuals with a Bachelor’s degree in health, human, social work or education services with one or more years of qualifying experience; or a high school degree or equivalent and three years of qualifying experience with case management of the aged, including management of behavioral health conditions, or persons with physical or developmental disabilities, or HIV/AIDS population.
the population served.

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

• Develop clinical knowledge and skills by learning about various processes and functions within the Managed Care industry
• Observe processes and shadow preceptors to gain hands on experience and become familiar with various clinical services
• Follow instructions and procedures provided by preceptor or manager in accordance with company guidelines

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) 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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

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

Position Purpose: Identify, facilitate and lead enterprise wide process improvement activities utilizing LEAN/Six Sigma methodologies to design and improve processes that support business infrastructure and performance.

• Identify, develop, and execute process improvement opportunities utilizing continuous improvement principles and LEAN/Six Sigma methodologies
• Prioritize and lead process improvement activities across the enterprise in support of all departments and functional areas
• Monitor process improvement projects and facilitate cross functional process improvement project teams ensuring deadlines and objective are met and return on investment is realized
• Consult with senior leadership and provide analysis and advice on a variety of performance and process related topics
• Provide training and guidance to project teams and functional areas to assist with the implementation and maintenance of process improvement activities
• Negotiate with project stakeholders to identify resources, mitigate risks, resolve issues and provide key performance indicators and project status
• Identify, communicate, and correct gaps in process performance and provide guidance to address these gaps
• Evaluate completed process improvement projects to identify and implement best practices and lessons learned

Education/Experience:

• Bachelor's degree in related field or equivalent experience. MBA or MHA preferred. 6+ years of LEAN, Six Sigma or related process improvement experience, preferably in the healthcare industry.

• Previous working knowledge of process mapping and design, statistical applications and project management software.

• Highly preferred experience supporting Dual Special Needs Plans (D-SNP)/Dual Eligible populations, Medicaid, ACA Marketplace/Exchange, Commercial products and operational processes.

Licenses/Certifications: LEAN/Six Sigma Black Belt or Master Black Belt certification preferred.

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

Program/Team Supported: Population Health – LTSS Care Management, SED Waiver

Travel: Approximately 50% field-based travel within Kansas typically within a one-hour drive.

Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. No weekends or holidays.

Location: Field-based in Kansas. Open to all Kansas candidates.

Preferred areas: Shawnee, Jackson, Nemaha, Brown, Atchison, Jefferson County, or nearby areas ( Northeast Kansas counties )

Position Purpose:
Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the most complex and high risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome
• Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
• Supports members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc
• Performs frequent home and/or other site visits (once a month or more), such as to assess member needs and collaborate with resources, as required
• Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits. Provides subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc
• Educates on and coordinates community resources, to include medical, behavioral and social services. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)
• Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources. Ensures identified services are accessible to members
• Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system. Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing and 2 – 4 years of related experience.

License/Certification:

• For Sunflower plan only: Licensed Behavioral Health Professional or RN based on state contract requirements e.g., LMSW, LCSW, LMFT, LMHC, LPC and RN with BH experience required

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

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required

Position Purpose:
Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professional judgment in assessing complex clinical information, validating diagnosis code assignments, and identifying discrepancies such as coding errors or upcoding. Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting regulatory requirements, and making authoritative decisions to ensure compliance with all applicable laws, payer contracts, and organizational policies.

• Independently conducts comprehensive MS-DRG and APR-DRG coding and clinical validation reviews, exercising professional judgment to verify ICD-10-CM/PCS assignments, validate clinical diagnoses, identify discrepancies, and apply inpatient reimbursement rules without direct supervision.
• Collaborates with the Medical Director on complex cases, providing expert recommendations and influencing review outcomes to ensure clinical accuracy and compliance.
• Leads the evaluation of complex cases and proactively identifies opportunities to develop medical policy in the absence of established guidelines, demonstrating discretion and authority in decision-making.
• Applies advanced knowledge of coding guidelines and clinical policies throughout the review process, making autonomous determinations regarding coding accuracy and regulatory compliance.
• Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, approved Centene policies, and adopted clinical guidelines, ensuring recommendations reflect professional expertise.
• Evaluates claims and medical records for compliance with state and federal regulations, payer contracts, and company policies, exercising independent judgment in interpreting requirements and resolving ambiguities.
• Consistently meets or exceeds established quality and productivity standards while managing priorities and workflow autonomously.
• Contributes to strategic initiatives by assisting in the development of audit concepts, identifying new audit opportunities, and selecting claims for review, demonstrating leadership in shaping audit methodologies.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Associate's Degree in Health Information Management, Nursing, or related field required

• 4+ years experience of performing MS-DRG and APR-DRG coding required
• 2+ years experience of performing DRG reviews for a Payment Integrity vendor or Payer required
• 2+ years experience of using DRG encoder/grouper experience (TruCode/TruBridge, 3M, Optum Encoder, Webstrat, PSI, or similar) required
• 1+ years experience of inpatient hospital documentation improvement preferred

Licenses/Certifications:
RHIT - Registered Health Information Technician required or
RHIA - Registered Health Information Administrator required or:
CCS-Certified Coding Specialist required or:
Certified International Credit Professional (CICP) required or:
CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State Licensure and/or Compact State Licensure Registered Nurse or Higher (in combination with a coding credential) preferred

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

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required

Position Purpose:
Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professional judgment in assessing complex clinical information, validating diagnosis code assignments, and identifying discrepancies such as coding errors or upcoding. Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting regulatory requirements, and making authoritative decisions to ensure compliance with all applicable laws, payer contracts, and organizational policies.

• Independently conducts comprehensive MS-DRG and APR-DRG coding and clinical validation reviews, exercising professional judgment to verify ICD-10-CM/PCS assignments, validate clinical diagnoses, identify discrepancies, and apply inpatient reimbursement rules without direct supervision.
• Collaborates with the Medical Director on complex cases, providing expert recommendations and influencing review outcomes to ensure clinical accuracy and compliance.
• Leads the evaluation of complex cases and proactively identifies opportunities to develop medical policy in the absence of established guidelines, demonstrating discretion and authority in decision-making.
• Applies advanced knowledge of coding guidelines and clinical policies throughout the review process, making autonomous determinations regarding coding accuracy and regulatory compliance.
• Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, approved Centene policies, and adopted clinical guidelines, ensuring recommendations reflect professional expertise.
• Evaluates claims and medical records for compliance with state and federal regulations, payer contracts, and company policies, exercising independent judgment in interpreting requirements and resolving ambiguities.
• Consistently meets or exceeds established quality and productivity standards while managing priorities and workflow autonomously.
• Contributes to strategic initiatives by assisting in the development of audit concepts, identifying new audit opportunities, and selecting claims for review, demonstrating leadership in shaping audit methodologies.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Associate's Degree in Health Information Management, Nursing, or related field required

• 4+ years experience of performing MS-DRG and APR-DRG coding required
• 2+ years experience of performing DRG reviews for a Payment Integrity vendor or Payer required
• 2+ years experience of using DRG encoder/grouper experience (TruCode/TruBridge, 3M, Optum Encoder, Webstrat, PSI, or similar) required
• 1+ years experience of inpatient hospital documentation improvement preferred

Licenses/Certifications:
RHIT - Registered Health Information Technician required or
RHIA - Registered Health Information Administrator required or:
CCS-Certified Coding Specialist required or:
Certified International Credit Professional (CICP) required or:
CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State Licensure and/or Compact State Licensure Registered Nurse or Higher (in combination with a coding credential) preferred

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

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a High School diploma or GED.
Requires 1 – 2 years of related experience

License/Certification:

• For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required

Preferred Qualifications:

• This is a field-based role supporting members with developmental disabilities needs. Candidates should have strong experience working with the Developmental Disabilities (DD) population. Applicants must reside in or be able to support members throughout Sebastian, Crawford, and Franklin Counties, Arkansas

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

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a High School diploma or GED.
Requires 1 – 2 years of related experience

License/Certification:

• For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required

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

Position Purpose:
The Senior Business Process Consultant leads business case development for proposed initiatives, supports the strategic planning process, and leads larger scale, cross-functional initiatives.

• Leads business case development for proposed initiatives to ensure adequate assessment of opportunities, risks and return on investment.
• Provides input and supports planning and prioritization of initiatives as part of the strategic and business planning process.
• Ensures that initiatives support the strategic business plan, meet key business objectives and are executed well tactically.
• Ensures that all approved business cases are transitioned to initiatives (both documentation and clear responsibilities for each initiative).
• Leads larger scale, cross-functional initiatives that are intended to drive performance improvement, financial gains, customer satisfaction and improved compliance.
• Provides strategic and policy guidance on assigned initiatives so that all processes are considered for maximizing effective implementation and results.
• Organizes work teams, drives consensus and ensures end to end policy/process integrity to accomplish project work: including identification and confirmation of participants, establishment of a project plan, consistent work team engagement and productivity, meeting facilitation, consensus building, recommendation documentation and implementation oversight.
• Performs detailed analysis of data, workflows, policies, procedures, organization of staff, and skills in order to execute initiatives.
• Supports the project work by utilizing project management software such as, but not limited to, Excel, PowerPoint, Visio, and Microsoft Project.
• Leads all levels of staff who are responsible for initiatives included in the companies operating plan in order to support their success, development and effective completion and communication of their initiative.
• Assists other project leaders in specific areas as needed such as facilitation, analysis, process mapping, brain-storming, project management issues, etc.
• Writes and delivers communication to all levels of organization to ensure support, awareness and effectiveness of process improvement initiatives.
• Provides other related support as needed to improve the performance of the business
• Performs other duties as assigned.
• Complies with all policies and standards.