Jobs for Humanity is partnering with Centene to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Centene

[Job Title] - Medical Management/Health Services Supervisor at Oklahoma Complete Health Are you passionate about making a difference in the lives of others? Join our team at Oklahoma Complete Health, a company committed to transforming the health of Oklahomans and providing quality healthcare solutions. We are looking for a compassionate and dedicated individual to be a part of our Medical Management/Health Services team. [Job Responsibilities] - Supervise a team of nurses in a highly regulated department responsible for performing medical necessity case reviews to ensure appropriate medical care and services. - Oversee day-to-day clinical operations, ensuring productivity and quality metrics are met. - Ensure timely processing of all appeals in accordance with legal requirements and clinical policies. - Monitor appeals and provide monthly reporting on trends to senior management. - Collaborate with staff to review projects, address work progress, and resolve any encountered problems, while maintaining compliance with departmental policies. - Engage with external entities such as state, local, and federal governments, local communities, and the public on issues related to grievances and appeals. - Implement changes in federal and state laws into the company's regulatory system for handling grievances and appeals. - Identify solutions to departmental challenges and work with staff to implement corrective measures and prevent future issues. - Provide coverage for internal and external program audits. - Occasional travel to other states, approximately 10% of the time. [Qualifications] - Bachelor's degree in a related field or equivalent experience. - Clinical, quality management, or healthcare-related experience, preferably in managed care. - Recent supervisory experience in a healthcare environment. - Current state RN license is required. - Certified Professional in Healthcare or other licensed clinical experience is preferred. [Compensation and Benefits] - Competitive pay. - Flexible work solutions, including remote options, hybrid work schedules, and dress flexibility. - 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. [Application Process] To apply for this position, please fill out the form below and attach your resume and cover letter. We value diversity and encourage applicants from all backgrounds, including but not limited to the elderly, refugees, people with visible and invisible disabilities, LGBTQIA+ individuals, and veterans. [Centene's Commitment] Centene is an equal opportunity employer that values diversity and recognizes the unique contributions each individual brings. We are committed to creating an inclusive culture where all employees feel valued and respected. 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 any other characteristic protected by applicable law. We look forward to receiving your application and having you join our collaborative team of innovative thinkers dedicated to delivering solutions at the local level. Together, we can make a difference in the lives of millions.