Director, Care Management

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🔥 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 care management of members to develop and assess high-quality, cost-effective healthcare outcomes • Develop strategies and objectives within care management 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 care management team performance, improvement, and talent management • Set team goals and objectives and oversee care management data and reporting metrics • Oversee development and implementation of care management policies and procedures to ensure compliance with federal, state, and NCQA standards • Stay current on trends and best practices in payer care management and related fields • Lead process improvements to achieve quality and cost-effective healthcare results • Contribute to development and improvement of clinical care pathways • Develop care management strategies and provide recommendations aligned with organizational objectives • Develop the department budget in collaboration with other departments and senior leadership • Develop onboarding, hiring, and training strategy for new care management team members • Perform other duties as assigned and comply with all policies and standards

🎯 Requirements

• Bachelor's degree • 7+ years of related experience (84+ months) • Prior management experience • Equivalent experience may substitute for the stated bachelor's degree through applicable knowledge, duties, scope, and skill • Current state Registered Nurse (RN) license preferred • Knowledge of payer care management and related fields • Ability to develop care management strategies, policies, procedures, budgets, and training programs • Ability to oversee performance, quality, cost-effectiveness, reporting metrics, and regulatory compliance • Compliance with all policies and standards

🏖️ Benefits

• Competitive pay • Health insurance • 401K plans • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Incentives may be included in total compensation