Director, Care Management

Centene
Missouri
Workplace: RemoteFull timeUSD 133,700 - 247,400 annuallyFunction: Executive & General ManagementExperience: 7+ yearsEducation: bachelorsSkills: ["Leadership","Strategic planning","Performance management","Process improvement","Cross-functional collaboration"]

Direct the care management team to develop and assess high-quality, cost-effective healthcare outcomes. Set strategies, goals, and performance metrics to improve member and/or provider experience, and oversee departmental operations including staffing, care management models, and use of information technologies. Lead compliance with regulatory requirements and NCQA standards, drive process improvements and clinical care pathway development, and collaborate on budgeting, onboarding, hiring, and training.

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FursaFursa
Centene
Centene
4 days ago

Director, Care Management

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Source: Company careers pageValidated by: Fursa AI
Last checked: 3 hours agoStatus: Live

Job Summary

Direct the care management team to develop and assess high-quality, cost-effective healthcare outcomes. Set strategies, goals, and performance metrics to improve member and/or provider experience, and oversee departmental operations including staffing, care management models, and use of information technologies. Lead compliance with regulatory requirements and NCQA standards, drive process improvements and clinical care pathway development, and collaborate on budgeting, onboarding, hiring, and training.
Location: Missouri
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Director level

Key Responsibilities

  • •Directs the care management team and the care management of members to develop and assess high-quality, cost-effective outcomes.
  • •Develops care management strategies, objectives, and departmental goals, and oversees data and reporting metrics to achieve quality and cost-effectiveness.
  • •Oversees departmental operations including the care management model, staffing, information technologies, and staff competencies.
  • •Leads process improvements and contributes to development and improvement of clinical care pathways.
  • •Directs compliance with care management policies and procedures to meet regulatory requirements and NCQA standards, and oversees onboarding, hiring, and training.

Pay and Benefits

Salary: USD 133,700 - 247,400 annually
Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

  • •Requires a Bachelor's degree and 7+ years of related experience, including prior management experience.
  • •Prior experience directing care management and improving quality and cost-effective healthcare outcomes.
  • •Knowledge of care management regulations and standards, including federal, state, and NCQA requirements.
  • •Ability to develop strategies, objectives, and reporting metrics for departmental performance.
  • •Current state Registered Nurse (RN) license is preferred.
Experience:7+ yearsHealthcareCare managementPayer
Education:Bachelor's
Skills:LeadershipStrategic planningPerformance managementProcess improvementCross-functional collaboration
Licenses:Registered Nurse (RN)
Tech Stack:Information technologies

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn