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Centene Corporation

Founded as a single health plan in 1984, Centene Corporation (Centene) has established itself as a national leader in the healthcare services field. Today, through a comprehensive portfolio of innovative solutions, we remain deeply committed to delivering results for our stakeholders: state governments, members, providers, uninsured individuals and families, and other healthcare and commercial organizations. Read More

Address      Centene Corporation Centene Plaza 7700 Forsyth Blvd. St. Louis, MO 63105
Website      www.centene.com/
Holding      No Holding Details

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Clinical Nurse

Position Purpose:
Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams

Knowledge/Experience:
Bachelor’s degree Business Administration, related field, or equivalent experience. 4+ years of clinical nursing experience, preferably in a large primary care office or clinic setting working with Medicaid or the uninsured. Experience working in managed care, utilization management, case management, or quality improvement highly preferred. Experience in conflict management or data reporting and evaluation.

License/Certifications: Current state’s LPN or LVN license, RN preferred

Position Responsibilities:
• Implement and manage procedures for tracking, identifying and problem-solving operational issues
• Interpret and present program results and develop data-driven analysis and metrics used to measure effectiveness and ROI of all current and new products
• Act as the clinical representative in various meetings
• Collaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction
• Serve as a resource and liaison on utilization, quality improvement, and case management activities
• Partner with various staff, along with internal and external departments on provider education and outreach
• Partner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data, and quality incentive payments
• Support community and member initiatives with a focus on at-risk targets
• 50% travel required

The position above is with Superior HealthPlan, a wholly owned subsidiary of Centene Corporation, located in Texas.

Superior HealthPlan is a leading multi-line healthcare organization that provides programs and related services to individuals receiving benefits under Medicaid, including enrollees in Temporary Assistance for Needy Families (TANF), the Children’s Health Insurance Program (CHIP), Supplemental Security Income (SSI)/Aged, Blind and Disabled (ABD), Foster Care and Medicare.

Superior HealthPlan offers competitive salaries and a broad range of comprehensive benefits to its employees. Some of those benefits are: Exemplary Health, Dental and Vision Insurance, 401(k) Retirement Plan, Employee Stock Purchase Plan, Tuition Reimbursement Program, and a generous Time Off policy.

Other Job Information

Vacancy type:

Full Time

Contact Mode:

not provided

Fax:

not provided

Contact Name:

not provided

Job Duration:

not provided

Phone:

(314) 725-4477

Email:

not provided

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