Director, Utilization Management – Hospice CoE

🔥 14 hours ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $133.7k - $247.4k / year

⏰ Full Time

🔴 Lead

👔 Director

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Accountable for the enterprise strategy, clinical governance, and operational execution of hospice and palliative care identification, referral, and utilization management • Directs the utilization management team to ensure the appropriate application of policy procedures and processes • Oversees and manages Utilization Operations specific to the daily operations of Utilization Management • Leads utilization management team on performance, improvement, and career growth path considerations • Establishes policies and procedures that incorporate best practices and ensure effective utilization reviews of members • Develops utilization management strategies and influences decisions by providing recommendations that align to organizational objectives

🎯 Requirements

• Requires a Bachelor's degree and 7+ years of related experience • RN - Registered Nurse - State Licensure and/or Compact State Licensure highly preferred • 4+ years management experience preferred • Expert knowledge of industry regulations, policies, and standards preferred • Must have experience creating pivot tables

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules