• Job Description

  Req#: 1428273

  You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

  Applicants for this position have the flexibility to work remotely in New York.
  
  Position Purpose: Internal consultant role responsible for assisting Clinical Operations leadership with the design, implementation, and monitoring of Health Benefit Ratio (HBR) initiatives and clinical performance improvement. This position is specifically intended to support the organization's ability to identify and implement new business initiatives related to care management and utilization management designed to improve quality, outcomes, and member satisfaction, while reducing costs. In the process of achieving these intended outcomes, the individual in this position will be identifying new opportunities for other initiatives, evaluating the cost and benefits of various alternative solutions, communicating actionable findings and recommendations to senior/ executive management, and then leading the initiative's implementation, ultimately monitoring the effectiveness of the implementation.

  Assist Senior and Executive leadership in the identification of performance improvement opportunities within Clinical Operations aimed at improving member health outcomes, reducing inappropriate utilization, and increasing both quality and member satisfaction.
  Perform research and analysis to determine scope, feasibility, and impact of implementing initiatives. Provide actionable recommendations, create executable roadmap for process redesign and implementation, and identify methodology and metrics for measuring success and monitoring outcomes.
  Manage initiatives aimed at the re-engineering of operational processes to improve efficiencies within the department, including but not limited to care/case management and utilization management.
  Re-engineer operational processes by streamlining workflows, improving system functionality, increasing value-add activities and interventions.
  Builds criteria to systemically evaluate both qualitative and quantitative attributes of new solutions implemented to ultimately measure results and drive additional recommendation to Senior and Executive Management
  Define scope and size of new solutions to inform executable roadmap for implementation and process redesign
  Key contributor to critical departmental documentation, including policies, procedures, process maps, training materials, and audit tools.
  Represent the department through participation in organization-wide strategic initiatives, collaborating with other operational areas to ensure successful implementations
  Provide strategic project leadership and management in implementation of new solutions and capabilities
  Self-motivated and able to work collaboratively as a member of a team as well as on one’s own as needed.
  Ability to facilitate discussions, ideate and narrate a story related to the work
  Adept at navigating change and creating pathways

  Education/Experience:

  • BA/BS – Bachelors Degree or equivalent required. MA/MS - Masters Degree or equivalent strongly preferred.
  • Five to eight years related experience required.
  • Proficiency in Microsoft Office: Excel, Word, Access; Lotus Notes; Internet, PowerPoint, Visio and adaptability in learning new technology.

  Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

  Pay Range: $82,600.00 - $148,700.00 per year

  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

  Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

• About the company

  Centene Corporation is a publicly traded managed care company based in St.

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