Centene

Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government-sponsored healthcare programs, focusing on under-insured and uninsured individuals.

The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

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Position Company Location Posted
Behavioral Health Clinical Care Mgr Centene Cypress, California US 05/24/2020
Description: Position Purpose: Handle inbound and outbound member and provider calls on a clinical phone queue. Ensure members receive behavioral health services appropriate to clinical need. Triage crisis calls to assist with stabilization and access to emergency evaluation. Coordinate services with other departments, such as medical case/care management. Perform utilization management functions, including authorization determinations and care shaping.Handle member ... More
Senior Behavioral Health Advocate Centene Chicago, Illinois US 05/24/2020
Description: Position Purpose: Coordinates the socioeconomic needs and service of selected member populations across the continuum of illness. Coordinates and plans activities and behavioral routines to meet the medical, social and emotional needs of members and their families. Provides support and/or intervention and assists members in understanding the implications and complexities of their current medical situation and/or overall personal care. Collaborates with the ... More
Care Manager I (RN) Centene Harrisburg, Pennsylvania US 05/24/2020
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 careDevelop, assess and adjust, as necessary, the care plan and promote desired outcomeAssess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment ... More
Utilization Review Nurse I Centene Getzville, New York US 05/23/2020
Description: Position Purpose: The Utilization Review Nurse I provides first level clinical review for all outpatient and ancillary services requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a professional and competent manner. Processes all prior authorizations to completion utilizing ... More
Utilization Review Nurse I Centene Latham, New York US 05/23/2020
Description: Position Purpose: The Utilization Review Nurse I provides first level clinical review for all outpatient and ancillary services requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a professional and competent manner. Processes all prior authorizations to completion utilizing ... More
Service Coordinator II Centene Detroit, Michigan US 05/23/2020
Description: Position Purpose: Determine needs and eligibility of members for various services through field-based collaboration with medical, behavioral, and social support staff. Conduct screening and risk assessment interventions per program guidelines.Conduct in-home face to face member assessments and telephonic outreachDocument assessments and contacts, develop and approve service plans, and ensure authorizations are completedConduct follow-up contacts ... More
Care Manager II (RN) Centene Wauwatosa, Wisconsin US 05/23/2020
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. 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 Utilize assessment skills and discretionary ... More
Utilization Management Specialist - Behavioral Health Centene Rego Park, New York US 05/22/2020
Description: Ensure all members are receiving the right care, in the right place, at the right time through Utilization Review and Discharge Planning work. Work with hospital staff, community agencies, members and families to coordinate effective and clinically appropriate discharge plans. Promote quality and cost effectiveness of healthcare by the appropriate application of policies and guidelines to prior authorization and concurrent review requests. Perform reviews of ... More
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