Director, Care Management

🔥 0 minutes 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

🛡️ 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 the care management team and member care management activities to develop and assess high-quality, cost-effective healthcare outcomes • Develop strategies and objectives to improve member and/or provider experience • Direct and evaluate departmental operations, including the care management model, staffing, information technology use, and staff competencies • Oversee team performance, improvement, and talent management • Set team goals and objectives and oversee care management data and reporting metrics • Develop and implement care management policies and procedures compliant with federal, state, and NCQA standards • Monitor trends and best practices in payer care management • Lead process improvements to achieve quality and cost-effective healthcare results • Contribute to clinical care pathway development and improvement • Develop care management strategies and recommendations aligned with organizational objectives • Develop the department budget in collaboration with other departments and senior leadership • Develop onboarding, hiring, and training strategies for new care management team members • Perform other duties as assigned and comply with policies and standards

🎯 Requirements

• Bachelor's degree and 7+ years of related experience, including prior management experience • Equivalent experience may substitute for the stated degree through applicable knowledge, duties, scope, and skills • Current state Registered Nurse (RN) license preferred • Knowledge of payer care management trends and best practices • Ability to develop care management strategies, policies, procedures, budgets, and clinical care pathways • Experience overseeing team performance, talent management, onboarding, hiring, and training • Ability to manage care management data, reporting metrics, staffing, information technology, and departmental operations • Ability to ensure compliance with federal, state, and NCQA standards • Ability to work PST hours supporting the West Region and Texas

🏖️ 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 • Incentive compensation may be included in total compensation • Workplace accommodation support