Centene Corporation
10,000+ employees
Founded 1984
🛡️ Insurance
💼 Consulting
🏥 Healthcare
Insurance • Consulting • Healthcare
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.
Director, Care Management – LTSS
Job not on LinkedIn
🕒 September 14
Where this job comes from
Posted on Centene Corporation's careers page, not through a job board
First seen by Remote Rocketship September 14
Still open on Centene Corporation's site. Checked 7 hours ago.
Centene Corporation
10,000+ employees
Founded 1984
🛡️ Insurance
💼 Consulting
🏥 Healthcare
Insurance • Consulting • Healthcare
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
• Direct long-term care of members to develop and assess high-quality, cost-effective healthcare outcomes • Develop strategies and objectives for long-term care management to improve member and provider experience • Lead long-term care management and the care management team on performance, improvement, and career growth • Lead policies and procedures to ensure compliance with corporate, state, and NCQA standards • Oversee and monitor staff work assignments and caseloads • Monitor, review, and sign off on contract-required reporting • Provide vendor oversight as applicable • Attend conferences and stay current on payer care management trends and best practices • Lead and present process improvements to achieve cost-effective healthcare results • Lead and coordinate large or special projects with other departments • Direct and evaluate departmental operations, including care management model, staffing, information technology, onboarding, and staff competencies • Review and monitor long-term care member data to identify trends and improve operating performance and quality care • Participate in internal and external audits • Contribute to clinical care pathways that enhance cost effectiveness while providing quality care • Develop strategies and influence decisions through recommendations aligned with organizational objectives • Coach and guide the care management team to improve member and provider experience and facilitate high-quality care • May develop the department budget with interdepartmental and senior leadership collaboration • May develop or contribute to onboarding, hiring, and training strategies • Serve as a consumer advocate for MLTSS enrollees in the Illinois Health Plan, including input into policy development, planning, decision-making, and oversight • Perform other duties as assigned • Comply with all policies and standards
🎯 Requirements
• Bachelor's degree • 7+ years of related experience • Prior management experience • Deep expertise in LTSS and Waiver programs • Experience presenting to leadership • Ability to analyze data • Ability to drive performance outcomes • Managed care experience strongly preferred • Must reside in Illinois or be open to relocating • Must be comfortable leading care management operations in Illinois • Knowledge of corporate, state, and NCQA standards • Ability to oversee long-term care management staff, assignments, and caseloads • Ability to review member data and comply with state and federal regulations • Experience or capability in vendor oversight, reporting, audits, care pathways, onboarding, hiring, and training • Equivalent experience may substitute for the stated education/experience through applicable knowledge, duties, scope, and skill
🏖️ Benefits
• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity
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