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.

Applicants must reside within the state of Florida.

Position Purpose: Leads and directs the long-term care management of members to develop and assess high quality, cost- effective healthcare outcomes. Leads and develops strategies and objectives within care management to improve member and/or provider experience.

• Provides oversight and leadership to the development, implementation, monitoring, and ongoing improvement of the long-term care management process

• Provides senior leadership team a vision and direction for the department to help achieve functional goals, and communicates goals to long-term care management team

• Oversees and monitors work assignments and caseloads of long-term care management staff based on state requirements, care management staff experience, and member needs

• Monitors, reviews, and signs off on contract required reporting as required

• Vendor oversight as required and applicable to the role

• Leads and enforces long-term care management policies and procedures within the care management team to ensure compliance with corporate, state, and National Committee for Quality Assurance (NCQA) standards

• Attends conferences and stays up to date on latest trends and best practices in Payer Care Management and related fields, as applicable

• Leads and coordinates large or special project work with other departmental functions

• Provides subject matter expert guidance to senior leadership and long-term care management team, which may include the latest long-term care management policies, procedures, and standards

• Reviews and monitors long-term care member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations, and participates with internal and external audits as required

• Reviews internal reports to ensure adherence to department budget and identify trends to effectively forecast

• Implements long-term care management strategies that align to organizational objectives

• Engages with onboarding, hiring, and training new long-term care management team members to support future growth and strategy

• Provides coaching and guidance to long-term care management team to improve member and provider experience and facilitate delivery of high-quality care

• Leads and manages process improvements for the long-term care management team to achieve cost-effective healthcare results and presents to senior leadership team as applicable

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 10+ years of related experience, including prior management experience.

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

Pay Range: $157,600.00 - $290,800.00 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. Total compensation may also include additional forms of incentives.

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