Centene Corporation jobs

Case Manager

Description: Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coord...

Behavioral Case Mgr

Description:Position Purpose\\: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members current functional level and, in collaboration with the member, develop and monitor the Case Management Care Plan, monitor quality of care; assisting with discharge plann...

Case Management Supervisor

Position Purpose: Supervise the day to day operations of the case Cmanagement function. Communicate with departmental and plan administrative staff to facilitate daily department functions. Assure compliance with established referral, pre-certification and authorization policies, procedures and processes by related Medical Services staff. Assure compliance with established onsite and concurrent review, case management, referral, pre-certification and authorization policies, procedures and pro...

RN Case Manager/Care Spec II

Position Purpose: The Case Manager/Care Coordinator II is responsible for the coordination of services and cost effective management of health care resources to meet individual members' health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members and HN to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant c...

Manager, Case Management (RN)

Position Purpose: Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions. Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes. Promote compliance with federal and state regulations and contractual agreements. Develop, implement and maintain compliance with poli...

Supervisor, Case Management – Health Net – Tigard

Description Position Purpose: Supervise the day to day operations of the case management function. Communicate with departmental and plan administrative staff to facilitate daily department functions. Assure compliance with established referral, pre-certification and authorization policies, procedures and processes by related Medical Services staff. Assure compliance with established onsite and concurrent review, case management, referral, pre-certification and authorization policies, procedu...

Medical Director (Community Outreach)

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance im...
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