Jobs at Centene Corporation

Manages IT program and project managers across waterfall and agile lifecycles. Oversees staffing, budgets, schedules, risks, quality, resources, and stakeholder interdependencies. Leads hiring, training, performance management, coaching, and team development while aligning programs with organizational objectives. Requires strong stakeholder, vendor, communication, negotiation, conflict management, and presentation skills, with knowledge of Agile, Scrum, SDLC, and project budget management.

Manages the implementation and operation of Identity and Access Management services, including technical support, process and report development, security control auditing, and business analysis. Leads IAM development programs, manages hiring and performance, coaches staff, communicates objectives, and provides technical guidance and organizational leadership.

Leads complex data analysis projects and supports business operations across claims, provider, member, clinical, HEDIS, pharmacy, and reporting functions. Extracts, loads, models, reconciles, and audits large datasets across platforms; develops management reports and dashboards; identifies trends, operational impacts, and improvement opportunities; ensures regulatory reporting compliance; and mentors other Data Analysts.

Leads complex data analysis projects and supports healthcare business operations across claims, provider, member, clinical, HEDIS, pharmacy, and reporting data. Extracts, loads, models, reconciles, and audits large datasets; develops dashboards and reports; identifies trends and operational impacts; and recommends actions to management. Mentors Data Analysts, helps allocate workloads, supports project implementation, and ensures compliance with reporting requirements.

Leads organization-wide quality improvement initiatives and national HEDIS audit and submission activities. Oversees quality assessments, file audits, reports, data analysis, process controls, policies, and compliance with internal and external guidelines. Identifies trends and improvement opportunities, recommends interventions, coordinates cross-functional teams, and supports quality committees. Requires leadership experience in quality management, auditing, reporting, and staff or project supervision.

Supervises community and resource coordination activities, assigns team workloads, monitors member outreach, ensures regulatory compliance, and supports effective care coordination. Coaches and evaluates team members, provides guidance on connecting members with local resources, and assists with hiring, onboarding, and training. Requires a bachelor's degree and at least four years of related experience, with Texas residency and U.S. work authorization without sponsorship.

Analyzes business needs, user requirements, processes, and operational data to support initiatives and improve performance. Conducts user acceptance testing, identifies implementation barriers, recommends business solutions, and supports successful system implementations. Develops reports, policies, procedures, training programs, and process improvements while serving as a subject matter expert for assigned functions. Collaborates across departments and may travel as needed.

Manages correspondence, appeals, disputes, and reconsiderations while ensuring regulatory, contract, NCQA, Medicaid, and internal policy compliance. Reviews reporting, identifies trends, recommends improvements, provides guidance on escalated issues, supports team hiring and training, and leads cross-functional process and quality initiatives.

Negotiate and manage provider and vendor contracts, implementations, relationships, financial performance, and operational reporting. Lead partnership reviews with health plans and executive stakeholders, conduct market analysis, present negotiation strategies, and develop corrective action plans or agreement modifications. The role requires healthcare contracting expertise, measurable financial results, remote work during Central Time hours, and up to 20% travel.

Provides strategic leadership for provider contracting, network development, and network optimization across multiple health plan product lines. Oversees contract negotiations, market expansion, network adequacy, budgeting, provider relationships, team leadership, regulatory compliance, and operational improvements. Collaborates with executive stakeholders and cross-functional teams to launch new markets, address performance gaps, and achieve affordability and network access objectives.

Leads large-scale healthcare technology migrations and enterprise programs, overseeing scope, schedules, budgets, risks, dependencies, cross-functional teams, executive communications, dashboards, training, and issue escalation. Coordinates project managers and business analysts while supporting clinical platform integration, interoperability, cutover, go-live, stabilization, and organizational transformation initiatives.

Leads complex provider and vendor contract negotiations, implementations, relationship management, financial analysis, operational reporting, and partnership performance tracking. Develops corrective action plans, modifies agreements, conducts market research, and presents negotiation strategies, performance data, scorecards, and partnership recommendations to health plans, corporate teams, and executives. The role supports affordability, network adequacy, and sustainable provider network outcomes.

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.

Leads national, multichannel marketing strategy and execution to drive acquisition and retention for ICHRA insurance plans. Oversees annual plans, media investment, creative and content, agency partnerships, SEO, analytics, ROI optimization, and consumer insights. Builds a digital-first, high-performance marketing culture; develops talent; influences product strategy; and collaborates with Sales, Product, Operations, Finance, HR, and Compliance to achieve growth and financial commitments.

Coordinates statewide clinical appeals, fair hearings, and external reviews. Evaluates clinical information using recognized medical-necessity criteria, prepares case reviews and compliant response letters, maintains appeal files and logs, and collaborates with medical directors to clarify determinations. The role also coordinates fair hearings, follows up with members and providers, and maintains knowledge of NCQA and Oregon regulatory requirements.

Direct LTSS business development, market expansion, proposal strategy, deal closing, licensing, implementation, risk mitigation, and regional business planning. Build relationships with providers, advocates, community leaders, regulators, and elected officials while overseeing staff and measuring project performance. Requires extensive healthcare market knowledge, leadership experience, and 75% travel.

Manage a team ensuring audit quality and performance for payment integrity initiatives related to potentially preventable readmissions, overseeing compliance and program results.

Lead vendor and internal payment integrity initiatives to achieve cost recovery and avoidance targets. Manage national vendor performance, develop budgets and forecasts, streamline processes, present findings to senior management, and support health plans on audit, compliance, and cost containment strategies.

Lead and monitor cost recovery and cost containment initiatives for health plans, manage internal and external vendors, develop budgets and savings targets, streamline processes, present findings and recommendations to senior management, and support compliance and auditing related to government programs.

Lead proposal development and capture efforts for business growth: set strategy, analyze RFPs, create proposal plans and compliance matrices, manage cross-functional teams, write/edit key proposal sections, run reviews, and oversee pipeline and opportunity reporting to support pursuit decisions.