Jobs at Centene Corporation

Lead enterprise-scale, cross-functional projects from initiation through delivery. Translate executive priorities into scopes, timelines, and governance. Coordinate across Quality, Analytics, Technology, Operations, vendors, and markets; manage risks, issues, dependencies, and change. Provide executive-ready status updates, facilitate governance and leadership reviews, and ensure adherence to enterprise PM standards to drive outcomes and delivery accountability.

Lead enterprise business transformation programs, coach and manage a transformation team, enforce methodology, prioritize portfolio initiatives, drive ROI-focused valuation, partner with senior leaders, and oversee resource allocation and execution across the organization.

Lead enterprise quality improvement for a national health plan: manage NCQA/HEDIS accreditation and performance, oversee risk-adjustment quality, collaborate on Medicare STARS (HEDIS/CAHPS/HOS), drive provider satisfaction and cultural competency/health equity initiatives, implement best practices and technologies, present results to senior leadership, and manage related policies, procedures and budgets.

Provide legal and strategic counsel for Centene's commercial health plan business on federal and state healthcare regulatory matters (ACA, parity, No Surprises Act, exchanges). Draft and negotiate contracts, advise cross-functional teams, manage subpoenas and disputes, engage outside counsel, and support implementation of regulatory and business initiatives.

Lead product strategy and delivery for utilization management correspondence systems. Define requirements, prioritize backlog, collaborate with technical teams to build compliant, modular document generation and automated notification workflows, test solutions, and drive sprint and release plans while aligning stakeholders to product vision.

Provide leadership and oversight of finance for the health plan, manage financial activities, analyze costs, support negotiations, and lead audits.

The role involves liaising with state government entities to enhance legislative policy and the regulatory environment for Centene's health plan, analyzing state legislative issues, and developing strategic relationships with policymakers.

Sell and manage specialty pharmacy services to prospective and existing clients. Build relationships, address client inquiries, monitor satisfaction, attend care conferences, support contract renewals and referrals, and collaborate with internal teams to resolve client issues.

Serve as primary liaison and account manager for assigned provider groups, ensuring accurate provider setup, directory and network reporting, and resolving complex provider claims and data issues. Oversee contractual provider relationships, provide training and support, research and interpret contracts and eligibility, and act as department subject matter expert.

Lead development and execution of leader and readiness communications for enterprise change. Create manager toolkits, talking points, FAQs, and readiness plans; design listening and feedback strategies; partner with HR and transformation leaders; support executive messaging and governance; monitor sentiment and measure effectiveness to ensure consistent leader communications.

Lead change and workforce engagement communications for enterprise integration and transformation. Coordinate communication calendars, align messaging across functions and health plans, develop engagement strategies, monitor employee sentiment, measure effectiveness, maintain governance, partner with leaders, and support enterprise-wide initiatives to drive clarity, consistency, and adoption.

Serve as the state government liaison to shape and influence legislative and regulatory policy affecting the state health plan and Centene. Build relationships with legislators and trade groups, analyze legislative/regulatory impacts, advise leadership, develop advocacy strategies and coalitions, represent the company to stakeholders, and manage staff and reporting to internal constituencies.

Lead identification, investigation, monitoring, and oversight of member and organizational incident reports to ensure compliance with CMS, ODM, and OAC. Coordinate with internal teams and state contractors, determine substantiation, oversee prevention plans, audit incidents, develop training, and review clinical documentation.

Lead business case development and large cross-functional initiatives to improve processes, financial performance, compliance, and customer satisfaction. Organize and facilitate work teams, perform detailed data and workflow analysis, support strategic planning, and oversee implementation. Use project management tools and lead staff across levels while communicating results and ensuring process integrity.

Lead continuous quality improvement initiatives, oversee accreditation processes, manage audits, and improve the quality of care and services provided by the organization.

Lead process improvement initiatives, manage NCQA audit timelines, and ensure compliance with accreditation standards while directing quality assurance and performance improvement projects.

The role involves coordinating preventive healthcare, member outreach, and ensuring compliance with care guidelines while supporting members in accessing health services.

Act as a liaison to improve pharmacy quality performance, collaborating with providers and pharmacies, and ensuring timely insights while managing territory engagement plans.

Manage a team ensuring audit quality and performance for payment integrity initiatives related to potentially preventable readmissions, overseeing compliance and program results.

Manage provider data management operations, supervise staff, oversee provider directory and contract setup activities, coordinate cross-functional projects with IS, design reports and workflows, ensure data integrity, train stakeholders, and support claims adjudication and process improvements.