Job Description

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose: Oversee and direct all clinical operations, including care management and coordination, and utilization management

Establish the business unit\xe2\x80\x99s clinical strategic vision, objectives, policies and procedures to ensure delivery of cost effective, clinically appropriate services in all markets for Sunshine Health enrollees
Monitor performance results against established metrics and benchmarks and recommend improvement opportunities
Lead operational team of Care Management and Care Coordination employees responsible for delivery of Medicaid Case Management services across state of Florida
Serve as the clinical subject matter expert and participate in all new implementations
Manage clinical oversight and assure compliance with Florida Medicaid Care management contractual responsibilities
Oversee integrated, holistic care management model for the Children\'s Health organization
Oversee the production of reports required by the contract and management
Collaborate with various departments to resolve enrollee health plan issues
Ensure effective care is delivered to members while achieving Population Health outcomes goals
Oversee annual budget for clinical operations
Drive efforts to increase staff expertise coordinate health services across Medicaid populations across Florida.

Education/Experience: Master\xe2\x80\x99s degree in Behavioral Health, Psychology, Public Health/Administration, related field or RN license. 8+ years of clinical and operations experience in the behavioral health industry. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. License/Certification: Unrestricted license as a LCSW, LMFT, LPC, PhD, PsyD or RN.

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.

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.

Sunshine State Health Plan