LogoFresh Jobs Ahead
Centene Corporation
Centene Corporation
SvetovanjeZavarovanjeZdravstveno varstvo
Centene Corporation je zdravstvena in zavarovalniška družba, osredotočena na zdravstveno kritje, ki ga podpira država, ter zdravje skupnosti. Njene storitve vključujejo Medicaid, Medicare, načrte zdravstvenega zavarovanja na trgu zdravstvenega zavarovanja in podporo programu TRICARE za vojaške skupnosti. Centene združuje lokalizirano zagotavljanje zdravstvene oskrbe s partnerstvi z neprofitnimi organizacijami, da bi zadovoljila potrebe članov, ki jim služi. Družba v svoj pristop k poslovanju in podpori skupnostim vključuje tudi odgovornost do okolja in etično upravljanje.
LinkedIn
Delovna mesta v podjetju

Remote Director of Utilization Management, Florida — Centene

Lead Florida utilization management teams and long-term care operations at Centene. Guide compliance, service performance, and initiatives that support member outcomes.

USZdružene države AmerikeFLFlorida
121.500 $ – 224.900 $ / leto
Na daljavoPolni delovni časVodjaZahtevani Jezik: angleščinaDirektor

Opis

  • Lead the utilization management team in applying policies and processes consistently to support strong member outcomes.
  • Run day-to-day utilization management operations, covering timeliness, quality, results, provider relationships, and regulatory compliance.
  • Coach the team on performance, continuous improvement, and career development.
  • Keep utilization management policies and procedures aligned with corporate, state, and NCQA requirements.
  • Examine utilization data, identify trends and patterns, and communicate their effects.
  • Drive operational improvements and share outcomes with senior leaders.
  • Set the policies and procedures that guide effective utilization reviews.
  • Shape utilization management plans and recommend actions that advance organizational goals.
  • Oversee assigned department budget areas and work with senior leadership.
  • Direct hiring, onboarding, and training plans for incoming team members.
  • Manage employees and partners across matrixed, cross-functional teams.
  • Support organizational change and take on other assigned responsibilities.
  • Follow applicable policies and standards.

Zahteve

  • Must live in Florida.
  • Bachelor’s degree and at least seven years of relevant experience, including management experience, or equivalent experience demonstrated through applicable knowledge, responsibilities, scope, and skills.
  • At least four years of management experience is preferred.
  • Substantial experience in long-term care utilization management.
  • Experience with Medicaid managed care, LTSS/LTC, prior authorization, and care management operations.
  • Expertise in industry regulations, policies, and standards is preferred.
  • Registered Nurse (RN) license in a state or compact state is preferred.

Ugodnosti

  • Competitive compensation.
  • Health coverage.
  • 401(k) plan.
  • Employee stock purchase plans.
  • Tuition assistance.
  • Paid leave and holidays.
  • Remote, hybrid, field, or office work arrangements, depending on role needs.
  • Total compensation may include additional incentive programs.
  • Equal opportunity employer with a commitment to diversity.

Sorodna delovna mesta

IQVIA

Clinical Research Associate, Sponsor Dedicated

IQVIA
Sponzor vizuma H1BProizvodnjaSvetovanjeTrženje
USZdružene države AmerikeFLFloridaKSKansasNJNew JerseyNCSeverna KarolinaUTUtah
74.500 $ – 197.500 $ / leto
Na lokacijiPolni delovni časJuniorSrednja ravenDiploma ni potrebnaZahtevani Jezik: angleščinaKlinične raziskave
Google Cloud Platform

Monitor clinical trial sites and support protocol compliance, patient recruitment, and study documentation for IQVIA. Coordinate with site staff and project teams to help trials meet quality standards and milestones.

Odpri
Regeneron

Clinical Study Specialist at Regeneron

Regeneron
Sponzor vizuma H1BBiotehnologijaProizvodnjaZdravstveno varstvo
USZdružene države AmerikeMAMassachusettsNJNew JerseyNYNew York
93.900 $ – 153.300 $ / leto
HibridnoPolni delovni časJuniorSrednja ravenZahtevani Jezik: angleščinaKlinični specialistSplošno
Google Cloud Platform

Support Regeneron clinical trial teams by coordinating study data, sites, reporting, and close-out activities. Help keep studies on track from site activation through completion.

Odpri