Senior Population Health Strategy Specialist

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

*M-F 8-5 EST/CST*

*Case Management/ Utilization Management knowledge*

*Project Management*

*Process Improvement*

*Must have exceptional computer, and analytical skills*

*Kentucky Medicaid*

Position Purpose: Plans and designs the population health strategy initiatives and programs to improve care coordination and health outcomes including developing efficiencies in programs (clinical and non-clinical). Monitors the effectiveness of care and identifying areas for process improvement to manage costs and to comply with federal and state regulations.

• Develops and designs complex population health strategy initiatives, programs, and operational plans to improve care coordination, health and qualify outcomes
• Managers, identifies, and tracks clinical, quality, documentation and data submission projects to achieve strategic objectives
• Monitors and researches care management trends and analytics to support program initiatives and efficiencies and help identify high risk member populations
• Develops financial budgets and forecasts for strategic planning and initiatives
• Partners with senior leadership team strategic planning initiatives in accordance with federal and state regulations and company policy
• Partners across departments to identify areas for process improvements to manage costs and support initiatives to improve health and quality outcomes
• Tracks and monitors program participation and member outcomes to access the efficacy of programs and interventions and make recommendations for improvement
• Partners with senior leadership team to provide insights to improve coordination of care, member utilization, and improve overall health and quality outcomes
• Collaborates with ensuring clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements
• May work across multiple Line of Business and states to encompass program needs into population health strategies
• Performs other duties as assigned
• Complies with all policies and standards

*M-F 8-5 EST/CST*

*Case Management/ Utilization Management knowledge*

*Project Management*

*Process Improvement*

*Must have exceptional computer, and analytical skills*

*Kentucky Medicaid*

Education/Experience: Requires a Bachelor's degree and 4 – 6 years of related experience.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range: $73,800.00 - $132,700.00 per year

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.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act