Director, Utilization Management – Post Acute Care

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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

⚕️ 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

• 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 • Reviews, analyzes, and reports on utilization trends, patterns, and impacts to deliver an effective utilization program • Establishes policies and procedures that incorporate best practices • Develops utilization management strategies and influences decisions by providing recommendations • Responsible for components of the department’s budget while collaborating inter-departmentally with senior leadership • Executes the overall strategy for onboarding, hiring, and training new utilization management team members • Leads and champions change within scope of responsibility

🎯 Requirements

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

🏖️ 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