You have the power to make a difference in the lives of 28 million individuals by joining our Medical Management/Health Services team as a clinical professional. Centene, a national organization, is dedicated to providing competitive benefits, including a flexible workplace, for all of our employees, regardless of their background or circumstances.

This job opportunity is specifically for those residing in Oklahoma.

Oklahoma Complete Health, a Centene company, is committed to improving the health of Oklahomans by offering high-quality healthcare solutions.

At Oklahoma Complete Health, we are advocates for the community and catalysts for change. We foster an inclusive culture that prioritizes work-life balance, fair compensation, and professional growth. Join us and become part of a collaborative network of innovative individuals dedicated to finding localized solutions.

Position Purpose:

As a member of our team, your role will involve managing the day-to-day operations of the care management functions. This includes maintaining communication with departmental and administrative staff to ensure smooth operations.

• Ensure the delivery of appropriate and cost-effective services to our members.
• Ensure compliance with government and company requirements in the care management department. You will be responsible for developing and implementing new procedures, managing regulatory filings, and addressing compliance issues.
• Establish and oversee care management policies and procedures, providing specific guidance to staff and departments as needed.
• Develop and implement care management programs that promote the use of necessary services and resources while maintaining the member's independence as much as possible.
• Supervise care management staff and facilitate ongoing communication between case managers, members, providers, and subsidiaries.
• Enhance staff skills through training and development opportunities.
• Resolve complaints, participate in audits and evaluations related to the Long Term Care Program, and implement corrective action plans if needed.

Education/Experience:

We are seeking candidates with a bachelor's degree in Social Work, Sociology, Psychology, Nursing, Gerontology, or a related field. Alternatively, if you have a LPN/RN license, you may also be considered. You should have at least 6 years of experience in long term care. Additionally, you should possess a sound understanding of case and/or utilization management. Familiarity with Medicaid managed care practices and policies, as well as CHIP and SCHIP, is preferred. Prior experience in a leadership or supervisory role is beneficial, including experience in hiring, training, assigning work, and managing staff performance.

A valid driver's license is required.

We offer a comprehensive benefits package that includes flexible work arrangements, such as remote options and hybrid schedules, as well as dress flexibility. On top of competitive pay, we provide paid time off, including holidays, health insurance coverage for you and your dependents, 401(k) and stock purchase plans, tuition reimbursement, and exceptional training and development opportunities.

At Centene, we are an equal opportunity employer that strongly values diversity and recognizes the importance of our unique individual backgrounds. We welcome qualified applicants from all walks of life, including but not limited to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.