You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

**Note: qualified candidates must reside in North Carolina. Approximately 10-15% travel.**

**Position Purpose:** Plans and designs the population health strategy initiatives and programs to improve care coordination and health outcomes including developing efficiencies in programs (clinical and non-clinical). Monitors the effectiveness of care and identifying areas for process improvement to manage costs and to comply with federal and state regulations.

+ Develops and designs complex population health strategy initiatives, programs, and operational plans to improve care coordination, health and qualify outcomes.

+ Manages, identifies, and tracks clinical, quality, documentation and data submission projects to achieve strategic objectives.

+ Monitors and researches care management trends and analytics to support program initiatives and efficiencies and help identify high risk member populations.

+ Make recommendations for interventions with providers and develop implementation and monitoring plans accordingly.

+ Develops financial budgets and forecasts for strategic planning and initiatives.

+ Partners with senior leadership team strategic planning initiatives in accordance with federal and state regulations and company policy.

+ Partners across departments to identify areas for process improvements to manage costs and support initiatives to improve health and quality outcomes.

+ Tracks and monitors program participation and member outcomes to access the efficacy of programs and interventions and make recommendations for improvement.

+ Partners with senior leadership team to provide insights to improve coordination of care, member utilization, and improve overall health and quality outcomes.

+ Collaborates with ensuring clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements.

+ May work across multiple Line of Business and states to encompass program needs into population health strategies including collaborating with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction.

+ Serve as a resource and liaison on utilization, quality improvement, and case management activities. Partner with various staff, along with internal and external departments on provider education and outreach. Support community and member initiatives with a focus on at risk targets.

+ Educate staff as necessary to ensure consistent performance and adhere to standards.

+ Research and respond to inquiries and issues.

**Education/Experience:**

+ Requires a Bachelor's degree and 4 – 6 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

+ Active RN license.

+ Experience in quality, care or case management, compliance, or managed Medicaid highly preferred.

Pay Range: $72,400.00 - $130,100.00 per year

Centene 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.