Centene Corporation GroupBusiness Analyst IV - Integration Quality & User Acceptance Testing (UM) Centene Corporation GroupBusiness Analyst IV - Integration Quality & User Acceptance Testing (UM)MO$87,700–$157,800 / yearPerform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements. Highly preferred that candidate has experience in Business Analysis, UAT, or Quality roles, as well as supporting integration testing and data/interface validation.
Centene Corporation GroupBusiness Analyst IV - Integration Quality & User Acceptance Testing (CM) Centene Corporation GroupBusiness Analyst IV - Integration Quality & User Acceptance Testing (CM)MO$87,700–$157,800 / yearPerform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements. Highly preferred that candidate has experience in Business Analysis, UAT, or Quality roles, as well as supporting integration testing and data/interface validation.
Centene Corporation GroupBusiness Analyst IV - Integration Quality & User Acceptance Testing (LTSS) Centene Corporation GroupBusiness Analyst IV - Integration Quality & User Acceptance Testing (LTSS)MO$87,700–$157,800 / yearPerform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements. Highly preferred that candidate has experience in Business Analysis, UAT, or Quality roles, as well as supporting integration testing and data/interface validation.
Centene Corporation GroupClinical Extern Centene Corporation GroupClinical ExternCAPosition Purpose: Observe preceptors and participate in various projects to learn and develop skills related to the Managed Care industry. Develop clinical knowledge and skills by learning about various processes and functions within the Managed Care industry.
Centene Corporation GroupSenior Manager, Marketing Centene Corporation GroupSenior Manager, MarketingTXRemote$87,700–$157,800 / yearOversee the writing, design and production of member and provider materials including newsletters, educational materials, handbooks, directories, manuals, member ID cards, promotional advertising, and website content while maintaining Corporate brand and style guidelines and state compliance requirements. Own end‑to‑end AEP readiness and execution across assigned lines of business, materials, and workstreams, ensuring all outputs are delivered on time, accurate, and compliant with regulatory, operational, and business requirements, while serving as the single point of accountability for AEP delivery from intake through final fulfillment.
Centene Corporation GroupChief Operating Officer, Illinois Health Practice Alliance Centene Corporation GroupChief Operating Officer, Illinois Health Practice AllianceIL$207,000–$392,100 / yearDevelop relationships with network providers, area employers, and contractors; ensure successful development and implementation of business plans. Develop and implement strategic and tactical plans to ensure further growth and development of the business unit and ensure positive financial results.
Centene Corporation GroupSenior Manager, Marketing Centene Corporation GroupSenior Manager, MarketingFLRemote$87,700–$157,800 / yearOversee the writing, design and production of member and provider materials including newsletters, educational materials, handbooks, directories, manuals, member ID cards, promotional advertising, and website content while maintaining Corporate brand and style guidelines and state compliance requirements. Own end‑to‑end AEP readiness and execution across assigned lines of business, materials, and workstreams, ensuring all outputs are delivered on time, accurate, and compliant with regulatory, operational, and business requirements, while serving as the single point of accountability for AEP delivery from intake through final fulfillment.
Centene Corporation GroupClinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthRemote-TX, TXRemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Centene Corporation GroupClinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthRemote-FL, FLRemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Centene Corporation GroupDirector, Quality & Process Improvement Centene Corporation GroupDirector, Quality & Process ImprovementMO$118,400–$219,000 / yearPosition Purpose: Lead and direct process improvement initiatives by utilizing process improvement methodologies in the analysis of current operations and design of improvement projects across all areas that impact operations. Oversee the administration, coordination and evaluation of quality assurance and training, including policy and procedure development, training assessments and quality adherence auditing.
Centene Corporation GroupSenior Business Systems Analyst Centene Corporation GroupSenior Business Systems AnalystRemote-CA, CARemote$87,000–$161,300 / yearPosition Purpose: Drives the collaboration with business and IT stakeholders to translate complex business requirements into comprehensive functional and non-functional technical specifications, ensuring alignment with strategic goals and solution design. Research, reviews, and analyzes the effectiveness and efficiency of existing requirement gathering processes and develop strategies for enhancing or further leveraging these processes; quantify potential efficiency opportunities and track accordingly.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthCedar Park, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthLubbock, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthLaredo, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthAmarillo, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthUvalde, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthMidland, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthWichita Falls, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthCorpus Christi, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthSan Antonio, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthMission, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthTemple, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthHouston, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupData Analyst IV Healthcare Analytics, Medical Economics Centene Corporation GroupData Analyst IV Healthcare Analytics, Medical EconomicsMIThis Data Analyst IV's work focuses on analyzing and running complex reports, understanding financial drivers and cost trends, and applying insights to optimize medical spend while maintaining quality of care. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthFort Worth, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthRemote-MO, MORemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Centene Corporation GroupBusiness Analyst II Provider Data Operations Centene Corporation GroupBusiness Analyst II Provider Data OperationsMO$56,200–$101,000 / yearSupport business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems. Identify ways to enhance performance management and operational reports related to new business implementation processes.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthWaco, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthSan Angelo, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthGeorgetown, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthDallas, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthMcallen, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthEl Paso, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClinical Review Therapist - Physical Health Centene Corporation GroupClinical Review Therapist - Physical HealthAustin, TX$30.58–$55.09 / hourPreferred Education/Experience: Master's degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred. Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment for members.
Centene Corporation GroupClaims Analyst II Centene Corporation GroupClaims Analyst IIRemote-MO, MORemote$19.43–$32.98 / hourFor External Candidates: 3+ years of health insurance industry experience, including claims processing, physician office, or related administrative experience required. Required to successfully complete Successful completion of claims basic training, COB advanced training, and ramp period.
Centene Corporation GroupLead Information Risk Analyst Centene Corporation GroupLead Information Risk AnalystCAThe Security Compliance Lead Information Risk Analyst is a senior individual contributor role with enterprise-wide responsibility for security governance, compliance execution, audit readiness, and GRC platform leadership. The role operates independently, leads complex cross functional initiatives, and serves as a subject matter authority, without formal people management responsibilities.
Centene Corporation GroupDirector, Risk & Compliance Processes & Initiatives Centene Corporation GroupDirector, Risk & Compliance Processes & InitiativesMO$118,400–$219,000 / yearPosition Purpose: Develops and implements strategies to ensure successful maintenance and implementation of compliance and risk programs that meet regulatory requirements for assigned products across the enterprise, leveraging strong collaboration, and project management skills to build and continuously improve governance, risk, and compliance (GRC) processes, controls, and tool capabilities, informed by a background in compliance and/or auditing and a person-centered approach to accomplishing goals. Develops a framework to evaluate and interpret data outputs and reporting generated from activities recorded in the GRC tool to ensure data-driven insights can be derived to guide decision-making and support regulatory, audit, and operational requirements.
Centene Corporation GroupSenior Director, Finance Centene Corporation GroupSenior Director, FinanceNYRemote$148,000–$274,200 / yearReview, communicate, and present strategic plans, operating budgets and forecasts Provide financial plan for performance variances, operating alternatives, program and investment initiatives. Position Purpose: Direct, negotiate and handle activities of the business units finance, accounting and analysis functions.
Centene Corporation GroupClinical Review Clinician Appeals RN Centene Corporation GroupClinical Review Clinician Appeals RNCA$27.02–$48.55 / hourEducation/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience. Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices.
Centene Corporation GroupMedical Director Centene Corporation GroupMedical DirectorRemote-SC, SCRemote$225,700–$428,900 / yearCentene Corporation is a leading provider of government-sponsored healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and families served by the Health Insurance Marketplace. Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
Centene Corporation GroupLead Information Risk Analyst Centene Corporation GroupLead Information Risk AnalystMOThe Security Compliance Lead Information Risk Analyst is a senior individual contributor role with enterprise-wide responsibility for security governance, compliance execution, audit readiness, and GRC platform leadership. The role operates independently, leads complex cross functional initiatives, and serves as a subject matter authority, without formal people management responsibilities.
Centene Corporation GroupExecutive Assistant to Chief Operating Officer Centene Corporation GroupExecutive Assistant to Chief Operating OfficerClayton, MO$33.71–$60.67 / hourGathers information for board meetings, programs, events or conferences by arranging facilities and caterers, issuing information or invitations, coordinating speakers, preparing materials and assisting with controlling event budget. Responsible for leading and providing executive level support for the EVP in partnership with multiple internal partners to ensure the efficiency of all company matters and functions.
Centene Corporation GroupQuality Care Member Advocate Centene Corporation GroupQuality Care Member AdvocateVisalia, CA$27.02–$48.55 / hourPerform home visits or community-based assessments to evaluate member needs and identify social determinants of health that may prevent members from accessing preventive or follow-up care, and facilitate care coordination. Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements, ensuring members receive the support needed to close care gaps and maintain continuity of care.
Centene Corporation GroupQuality Practice Advisor Centene Corporation GroupQuality Practice AdvisorKY$27.02–$48.55 / hourDelivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements. Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure.
Centene Corporation GroupNewRemote National Medical Director Centene Corporation GroupRemote National Medical DirectorINRemote$236,500–$449,300 / yearCollaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. 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.
Centene Corporation GroupClinical Extern Centene Corporation GroupClinical ExternColumbia, SCPosition Purpose: Observe preceptors and participate in various projects to learn and develop skills related to the Managed Care industry. Develop clinical knowledge and skills by learning about various processes and functions within the Managed Care industry.
Centene Corporation GroupNewVice President, Legislative & Government Affairs Centene Corporation GroupVice President, Legislative & Government AffairsIndianapolis, IN$180,400–$343,300 / yearRepresent and serve as point person for the state health plan and Centene Corporation to outside trade groups/stakeholders including state AHIP organization, state medical association, state hospital association and related Medicare and Medicaid business vendors. Balance reporting requirements to multiple constituencies including; Centene Corporation regional vice president, state health plan president, chief operating officers and Corporate regulatory and government affairs staff.
Centene Corporation GroupSenior Manager, Marketing Centene Corporation GroupSenior Manager, MarketingMORemote$87,700–$157,800 / yearOversee the writing, design and production of member and provider materials including newsletters, educational materials, handbooks, directories, manuals, member ID cards, promotional advertising, and website content while maintaining Corporate brand and style guidelines and state compliance requirements. Own end‑to‑end AEP readiness and execution across assigned lines of business, materials, and workstreams, ensuring all outputs are delivered on time, accurate, and compliant with regulatory, operational, and business requirements, while serving as the single point of accountability for AEP delivery from intake through final fulfillment.
Centene Corporation GroupDental Operations Manager Centene Corporation GroupDental Operations ManagerCAPosition Purpose: The Dental Operations Manager is responsible for managing, directing and supporting the dental operations for our Medi-Cal, Healthy Families and Medicare members. The director is also responsible for ensuring compliance with our Department of Health Services (DHS) and Healthy Families MRMIB contracts.
Centene Corporation GroupDRG Reviewer Centene Corporation GroupDRG ReviewerMO$70,100–$126,200 / yearEducation/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.