Remote MRU Clinical Supervisor

Centene

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Business Area: Clinical & Care Management
Job Type: Full time
Date Posted: Jun 06 2024
Job Number: 1502248

Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Candidate must reside in the state of Arizona.

Position Purpose:

Supervise the day to day operations of the medical management, utilization and case management functions.

  • Oversee changes to medical service functions and performance in relation to company mission, philosophy objectives and policies, as directed
  • Assist senior management with budgets and forecast for strategic planning and key initiatives. Balance current future needs effectively
  • Ensure compliance with established onsite and concurrent review, case management, referral, pre •authorization policies, procedures, and processes
  • Assure that Medical Services functions and responsibilities are coordinated with other operating departments of the Plan and Corporate
  • Assist senior management with statistical analysis of utilization data
  • Participates in NCQA accreditation of the Plan
  • Participate in case review with Medical Directors and act as resource for appeals function

Education/Experience: Nursing degree, state registered nursing license, and advanced degree preferred. 3+ years nursing experience. 1+ year quality improvement, case/utilization management in a healthcare environment, preferably managed care. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

Pay Range: $67,400.00 – $121,300.00 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.