Director, Care Management

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

Direct and evaluate the care management team for Medicare members, setting strategies, goals, and performance metrics to deliver high-quality, cost-effective healthcare outcomes. Lead operations including staffing, the care management model, and use of information technologies, and oversee compliance with regulatory and NCQA standards. Drive process improvements, develop clinical care pathways, and shape hiring, training, and budgeting in partnership with senior leadership while staying current on payer care management best practices.

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FursaFursa
Centene
Centene
22 hours ago

Director, Care Management

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 4 hours agoStatus: Live
Reposted: similar role first listed 6 days ago

Job Summary

Direct and evaluate the care management team for Medicare members, setting strategies, goals, and performance metrics to deliver high-quality, cost-effective healthcare outcomes. Lead operations including staffing, the care management model, and use of information technologies, and oversee compliance with regulatory and NCQA standards. Drive process improvements, develop clinical care pathways, and shape hiring, training, and budgeting in partnership with senior leadership while staying current on payer care management best practices.
Location: Missouri
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Director level

Key Responsibilities

  • •Direct the care management team and oversight of members’ care management to improve healthcare outcomes.
  • •Oversee departmental operations including the care management model, staffing, information technologies, and staff competencies to meet performance and quality objectives.
  • •Set goals and objectives, and oversee care management data/reporting metrics to achieve quality and cost-effective results.
  • •Oversee development and implementation of care management policies/procedures to ensure compliance with regulatory and NCQA standards.
  • •Lead process improvements and contribute to development of clinical care pathways to enhance cost effectiveness while providing quality care.

Pay and Benefits

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

Key Requirements

  • •Bachelor’s degree with 7+ years of related experience, including prior management experience.
  • •Prior management experience leading a care management/healthcare team.
  • •Experience developing and assessing care management strategies, objectives, and performance/quality outcomes.
  • •Knowledge of care management policies/procedures and compliance with regulatory requirements and NCQA standards.
  • •Experience building onboarding, hiring, and training strategies to ensure adequate training and high-quality care.
Experience:7+ yearsMedicarePayer care managementHealthcare
Education:Bachelor's
Skills:LeadershipStrategic planningProcess improvementTeam managementStakeholder collaboration
Licenses:RN license

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