Senior Manager, Care Management

2 weeks ago

Columbia, South Carolina, United States Centene Corporation Full time
Job Summary

Centene Corporation is seeking a Senior Manager, Care Management to oversee the care management team and develop high-quality, cost-effective healthcare outcomes. As a key member of our team, you will be responsible for facilitating member and provider needs through the complete care management cycle.

Key Responsibilities
  • Provide guidance and direction to care management teams to maintain compliance with federal and state regulations and contractual agreements.
  • Review, create, and maintain care management policies and procedures to ensure quality and cost-effective healthcare results.
  • Set goals and objectives for care management teams and oversee data and reporting metrics to achieve quality and cost-effective healthcare outcomes.
  • Partner with internal and external stakeholders, including members, providers, and regulators, to ensure seamless care coordination.
  • Manage and provide guidance on processes for escalation and/or complex cases to team members to address member needs.
  • Develop strategies and participate in cross-functional projects to improve quality of care outcomes and deliver cost savings.
  • Oversee the implementation of process improvements for the care management team to achieve cost-effective healthcare results.
  • Educate and provide resources for care management leaders on key initiatives and member outreach to facilitate ongoing communication between care management teams, members, and providers.
  • May perform telephonic, digital, home, and/or other site outreach to assess member needs and collaborate with resources.
  • May oversee, coordinate, and facilitate the training of care management team members to ensure adequate training and high-quality care to improve member and provider experience.
  • Supports in developing the overall strategy for onboarding, hiring, and training new care management team members.
  • Leads and champions change within scope of responsibility.
  • Performs other duties as assigned.
Requirements
  • Graduate from an Accredited School of Nursing or a Bachelor's degree and 6+ years of related experience, including prior management experience.
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required.
  • South Carolina: Alternate Licensure applicable - RN, LPC, or MSW, LCSW.
Benefits

Centene offers a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules.

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