Jobs at Centene Corporation

Provides lead-level onsite and remote technical support for end users and IT infrastructure. Troubleshoots hardware, software, operating system, network, voice, WiFi, and security issues; installs and upgrades systems; manages hardware setup, imaging, data transfers, and service tickets; coordinates with infrastructure teams and vendors; and trains users. Requires a high school diploma or GED and at least four years of related experience.

Performs advanced business and technical analysis, develops reports and database solutions, designs and implements business applications, documents requirements, troubleshoots systems, and recommends process improvements. Acts as a subject matter expert, collaborates with end users and departments, supports testing and debugging, evaluates financial impacts, monitors projects, resolves complex issues, and trains staff.

Manage risk adjustment and quality improvement processes for assigned healthcare products and plans. Develop cross-functional action plans, business requirements, operational workflows, and risk adjustment strategies. Support health plan initiatives, monitor competitive and local market factors, prepare management dashboards, and identify improvement opportunities. The role requires healthcare industry experience, with managed care, Medicare, Medicaid, Marketplace, long-term care, and New York MLTC experience preferred.

Conducts UAS assessments and coordinates personalized long-term care plans for complex, high-acuity members. Evaluates service needs, monitors member status and care outcomes, collaborates with providers and caregivers, facilitates authorizations and community resources, documents activities for regulatory compliance, and educates members and families. The role may also coach and precept new clinical hires.

Conducts field-based UAS assessments for complex long-term care members, evaluates medical and support needs, develops and updates person-centered care plans, coordinates providers and community resources, monitors member conditions, educates families, and ensures regulatory compliance. The role also supports service authorizations, quality improvement, member advocacy, and may precept and coach new clinical hires.

Oversee revenue forecasting, membership reporting, financial modeling, budgeting, scenario planning, and financial analysis across geographies and sales channels. Manage period-end close processes and analytical reporting packages while modeling market penetration and membership projections. Lead financial and data analysts, oversee performance management, and drive improvements in reporting accuracy and timeliness.

Provides enterprise leadership for clinical pharmacy operations and pharmacy benefit management across multiple health plan products and locations. Oversees P&T governance, formulary strategy, drug pipeline management, trend and high-cost therapy strategies, manufacturer relationships, rebate negotiations, vendor oversight, regulatory compliance, and pharmacy spend optimization. Partners with cross-functional teams to improve member access, quality, affordability, and business performance while setting strategic objectives and managing pharmacy program initiatives.

Lead enterprise-wide programs transforming contact center and telephony platforms from Avaya to AWS Connect. Manage scope, schedules, budgets, resources, risks, dependencies, and cross-functional teams. Coordinate project managers and business analysts, provide executive dashboards and steering committee updates, resolve escalated issues, and support training and process improvement. The role requires strong program leadership, executive communication, and experience delivering complex IT initiatives in high-visibility environments.

Provides consultative support to healthcare providers by analyzing performance, member engagement, quality, utilization, cost, and risk data. Develops reports and presentations, facilitates performance improvement discussions, educates providers on value-based performance tools, and presents Health Benefits Ratio analyses for operating committee meetings. Requires collaboration with health plan quality teams and provider reimbursement expertise.

Provides consultative support to healthcare providers by analyzing performance, member engagement, quality, utilization, cost, risk, and reimbursement data. Identifies improvement opportunities, facilitates provider performance discussions, prepares reports and presentations, and supports value-based performance education. Collaborates with health plan quality teams and presents Health Benefits Ratio analyses to leadership committees. This is a field-based role in the New York City area.

Leads strategy and execution for ICHRA provider networks across multiple markets. Responsibilities include provider network development, value-based contracting, contract negotiations, provider performance improvement, budgeting and forecasting, stakeholder relationships, advisory boards, governance, and network expansion. The role manages network development staff and requires extensive healthcare administration, managed care, provider contracting, and leadership experience.

Leads enterprise talent initiatives including leadership development, succession planning, and talent readiness programs. Manages projects through the full lifecycle, including requirements, planning, budgeting, resourcing, execution, risk mitigation, documentation, and stakeholder communication. Partners with HR leaders and business stakeholders to align resources, resolve issues, and support workforce transformation. The role requires onsite attendance and candidates local to or within driving distance of St. Louis.

Develops high-scoring written responses to complex Medicaid RFPs supporting new business and renewals. Collaborates with subject matter experts, ensures compliance with proposal requirements, creates advance topic papers, serves as a functional-area subject matter expert, supports reporting and competitive intelligence, and mentors proposal staff. Occasional evening and weekend work may be required during peak procurement periods.

Lead FP&A and G&A finance for a business unit: develop and monitor annual operating plans, forecast and analyze financial performance, manage headcount planning, identify medical cost trends and improvements, support contract financial impact and negotiations, oversee pricing models, reporting strategy, and coordinate with actuaries and senior management.

Lead and oversee the Gold Card Program, driving long-term program development, integration across business units, and ensuring consumer experience, clinical, and engineering expertise inform product design. Manage adaptive technology integration, team-based services for behavior change outcomes, and evaluate financial performance and value propositions for program enhancements and new development.

Lead design, development, implementation, and support of enterprise Identity and Access Management solutions (SailPoint IIQ/IdentityNow). Build/configure connectors, code lifecycle event management, troubleshoot IAM issues, enforce IAM policies, coordinate cross-functional teams, and drive IAM technical strategy, standards, and documentation.

Reviews Applied Behavioral Analysis services for medical appropriateness, conducts behavioral health prior authorizations, analyzes member data, collaborates with providers, educates members and families, and recommends care process improvements. Requires an independent clinical license or BCBA certification, behavioral health and ABA expertise, and experience assessing ABA treatment plans and utilization.