Job Description

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.Position Purpose: Conduct and manage the daily operations of the case management function

• Ensure successful transition of care for members from case management to the utilization management
• Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes.
• Develop, implement and maintain compliance with policies and procedures regarding medical case management
• Ensure compliance with federal and state regulations and contractual agreements
• Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure

Candidate must reside in the state of Arizona.Education/Experience: Bachelor\xe2\x80\x99s degree in nursing or equivalent experience. 4+ years of combined clinical nursing and case management experience. Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.License/Certification: RN license, Licensed Clinical Social Worker (LCSW), or Licensed Clinical Professional Counselor (LCPC), valid driver\xe2\x80\x99s license and automobile insurance. Case Management Certification (CCM) preferred.For Arizona Complete Health - Complete Care Plan:
Education/Experience: Bachelor\xe2\x80\x99s degree in nursing or equivalent experience. or behavioral health related Master\'s degree. 4+ years of combined clinical nursing and case management experience. Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
Children\xe2\x80\x99s team - must have experience working with children who have chronic or complex conditionsLicense/Certification: RN license, Licensed Clinical Social Worker (LCSW), License Masters Social Worker (LMSW) or Licensed Clinical Professional Counselor (LCPC). Valid driver\xe2\x80\x99s license and automobile insurance. Case Management Certification (CCM) preferred.
Pay Range: $103,500.00 - $191,600.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual\'s skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.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.

Arizona Complete Health