Centene Jobs in the United States
Centene Corporation
TACOMA, WA
Position Purpose:** The Senior Health Equity Specialist is responsible for maintaining compliance with regulations and contractual obligations pertaining to Culturally and Linguistically Appropriate Services (CLAS) and Health Equity within State Health Programs, Commercial and Medicare product lines. The Senior Health Equity Specialist ensures that culturally and linguistically appropriate services are provided to members, including identifying and implementing health equity initiatives, representing the health plan on national, regional and multi-plan initiatives and assessing operations for gaps.
Centene Corporation
Olympia, WA
Position Purpose:** Centene's Detection Engineering team drives threat-informed defense by designing, implementing, and continuously improving high-fidelity detections across endpoint, identity, network, cloud, and SaaS telemetry. As a Senior Detection Engineer, you will lead complex detection initiatives, architect coverage strategies, and mentor engineers while partnering closely with SOC/CSMT, CSIRT, Threat Intelligence, and platform owners.
Centene Corporation
Olympia, WA
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. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.
Centene Corporation
Olympia, WA
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. (some flexibility)** + **50%-75% travel within King County** + **Coordinate care for high-risk members; connect to health plan benefits and community resources** + **Address barriers to care (housing, transportation, food insecurity, etc.)** + **Conduct phone outreach to members** + **Visit members at home and in community settings (hospitals, shelters, provider offices, etc.)** **Position Purpose:** Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes.
Centene Corporation
TACOMA, WA
Required Licensure** Candidates must hold **one (1) of the following active licenses** : + **Registered Nurse (RN)** - _behavioral health experience required_ + **Licensed Clinical Social Worker (LCSW)** + **Licensed Mental Health Counselor (LMHC)** + **Licensed Professional Counselor (LPC)** + **Master of Social Work (MSW)** + **Licensed Marriage and Family Therapist (LMFT)** + **Licensed Professional Clinical Counselor (LPCC/CC)** + **Chemical Dependency Professional (CDP)** **Position Purpose:** Analyze, develop and monitor clinical QI activities to ensure compliance with customer expectations and lead clinical quality initiatives. Review clinical information for appeals to determine medical necessity of services, prepare reviews for cases, act as the liaison for appeals and fair hearings.
Centene Corporation
Olympia, WA
Develops or contributes to the development of ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care + Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure identified 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 + 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 + Identifies problems/barriers for care coordination and appropriate care management interventions for members with higher level of care needs + Reviews referrals information and intake assessments to develop or assist in the development of appropriate care plan/service plan for members with higher level of care needs + Collaborates with healthcare partners as appropriate to facilitate member care to ensure member needs are met and determine if care plan/service plan revision is needed + 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 managers and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits + Serves as a Subject Matter Expert (SME) to support the care navigation team and/or serve as a preceptor for newly hired staff + Other duties or responsibilities as assigned by people leader to meet the member and/or business needs + Performs other duties as assigned. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.
Centene Corporation
Olympia, WA
Experience with Washington State Medicaid and/or the Washington State Health Care Authority (HCA) is strongly preferred.***** **Position Purpose:** Interacts extensively with the behavioral health leadership and cross functional associates within the organization to develop and implement long range behavioral health program strategies. Candidate Education: Required A Bachelor's Degree in counseling, social work, psychology, nursing, or related human service field + Project leads behavioral health and/or behavioral health home program development and integration activities both internally and externally.
Centene Corporation
Olympia, WA
Guides and conducts special projects; reviews and provides interpretation of application instructions from regulatory agencies (Department of Insurance (DOI) and Centers for Medicare & Medicaid Services (CMS)) and assists in the development of and implementation of auditing and monitoring strategies for medium/high-risk states. + Oversees and prepares Qualified Health Plan templates and/or formal regulatory filing documents, seeking approval of our individual commercial marketplace health plans for Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF)filings for high-risk states.