Centene Corporation

Account Manager

• Manage client accounts through implementation and assigned accounts
• Resolve day to day issues for clients and assist Account Executive on aspects of supporting client specific strategic plans
• Serve as the day-to-day contact for assigned accounts, interacting with client contacts to facilitate problem resolution and promote high client satisfaction
• Work cross functionally with internal departments regarding client needs and requests
• Assist the Account Executive with account renewals, benefit enrollment meetings, and overall compliance with client contracts
• Manage plan setup and benefit configuration of new and existing clients in PBM system
• Participate in new client implementation meetings, finalists meetings, conferences and tradeshows
• Document appropriate client specific information in Salesforce.com
• Review reports and pharmacy benefit recommendations with clients quarterly and annually

Manager

• Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members
• Evaluates the needs of the member via phone or in-home visits
• Develops ongoing care plans for members with high level acuity
• Facilitates care coordination and collaborates with appropriate providers or specialists
• Collects, documents, and maintains member information and care management activities
• Provides education to members and their families

Behavioral Health Care Manager, LCPC, LCSW, RN, LMFT

Program Manager

• Coordinate and execute ongoing skills validation planning cycles—gathering requirements, creating plans and schedules, and managing resources.
• Support the connection of skills data outputs to learning content and talent management programs.
• Assist in the operational upkeep of enterprise skills data.
• Create enablement materials—quick reference guides, one-pagers, FAQs.
• Support leadership reporting needs; build dashboards and data visualizations.

Program Manager, Enterprise Learning & Talent

Marketing

• Develop and coordinate materials and marketing activities company wide
• Develop, coordinate and promote new programs for existing and new business initiatives
• Identify, develop and implement department processes and initiatives
• Identify and implement tracking method for marketing activities to monitor performance and success
• Assist, review, and provide feedback to subsidiaries on marketing campaigns and initiatives
• Coordinate approval of marketing and communication materials through the compliance system
• Monitor news that impacts Centene, its subsidiaries and/or the industry
• Develop and maintain relationships with printers, graphic artists and various vendors to facilitate development of marketing material
• Performs other duties as assigned
• Complies with all policies and standards

Senior Marketing Specialist

Procurement

• Manage vendor relationships and ensure vendor compliance with established internal and/or regulatory performance metrics.
• Accumulate, monitor, and report on vendor performance metrics to business unit management.
• Communicate expectations and vendor performance against established performance metrics to vendors, including development, implementation and follow up on annual vendor goals and targets.
• Ensure applicable vendor performance improvement plans and/or corrective action plans are initiated and completed as expected.
• Ensure vendors sustain required performance improvements/outcomes through verification audits.
• Conduct oversight meetings which include vendors, internal partners, and other stakeholders as appropriate.
• Oversee health plan participation in annual delegation audits.
• Provide follow-through on audit deficiencies to assure corrective actions are implemented.
• Facilitate communication to/from vendors and internal partners.

Director, Vendor Management

Account Executive

• Provide sales coverage and develop best possible market penetration for all products to present and prospective accounts in his/her assigned territory in accordance with company's policies and programs.
• Provide greater access to health insurance, by providing education and assistance to Medicare individuals.
• Distribute health education materials and arrange for health screenings.
• Provide Facilitated Enrollment, help facilitate the continuance of health insurance, and offer assistance with recertification.
• Identify prospective enrollees and determine eligibility for participation in the Advantage Medicare product.
• Understand and apply all policies and procedures pertaining to: Disclosures and provisions of the Advantage Medicare product, and Enrollment and Disenrollment.
• Develop a presence in the local community to help generate enrollments.
• Conduct home visits and personalized appointments as needed to complete the enrollment process.
• Market Advantage on-site at hospitals, senior centers, assisted living facilities, community events and other sites as designated.
• Understand the covered benefits, non-covered benefits, exclusions and exemptions.
• Assist members in accessing health care, transportation needs and other services or issues as they occur and pertain to members.
• Keep informed and adhere to current information pertaining to marketing activity guidelines set forth by various regulatory agencies—this includes providing enrollees with all corresponding materials and documentation.
• Keep alert to competitive products and marketing practices, and to keep management informed concerning them.
• Conduct and participate in telemarketing/outreach efforts as required.
• Attend and participate in sales meetings, training programs, conventions, and special events.
• Complete applications in a timely and accurate manner.
• Submit special reports regarding the operation of the territory, acceptance or rejection of products, and competitive conditions beneficial to other Marketing representatives and company operations.

Medicare Sales Representative

Security Engineer

• Partners with either Health Plans or Shared Services to translate privacy, security, artificial intelligence (AI), business continuity, and related requirements from client contracts, laws, and regulations into actionable enterprise controls
• Builds trusted relationships with Health Plan leadership and key stakeholders to ensure contract assurance, readiness reviews, Request for proposal (RFP) support, timely deliverable fulfillment, compliance reporting, and continuous improvement
• Drives early engagement with Enterprise Privacy, Security and Risk Management (EPSRM) visibility and influence across the organization
• Lead EPSRM engagement with Health Plans or Shared Services to ensure privacy, security, AI, and business continuity requirements are clearly understood, implemented, and monitored
• Interpret and translate regulatory, contractual, and legal requirements into operational controls and guide stakeholders on compliance expectations
• Validate and manage compliance evidence, deliverables, and audit readiness, including responses to regulators, clients, and internal/external auditors
• Build and maintain strong relationships with leadership, operational teams, and regulators to remove obstacles, resolve issues, and support consistent compliance practices
• Track regulatory, legislative and contract changes, assess organizational impact, and communicate required actions while supporting scalable control updates
• Oversee the accuracy and completeness of privacy, security, AI, and business continuity documentation, including plans, attestations, questionnaires, and related submissions
• Enhance enterprise engagement processes by driving standardized procedures, governance practices, templates, and continuous improvement efforts
• Support new market entries, RFP responses, contract renewals, and business expansion by providing specialized EPSRM subject‑matter expertise
• Identify risks and control gaps, recommend mitigation strategies, and contribute to improved compliance maturity across the enterprise.
• Performs other duties as assigned.
• Complies with all policies and standards.

Privacy & Security Enterprise Engagement Officer

Director

• Directs the utilization management team to ensure the appropriate application of policy procedures and processes
• Oversees and manages Utilization Operations specific to daily operations of Utilization Management
• Leads utilization management team on performance, improvement, and career growth path considerations
• Reviews, analyzes, and reports on utilization trends, patterns, and impacts
• Develops utilization management strategies and influences decisions

Director, Utilization Management

• Oversee and manage the functions of the quality improvement program
• Provide support to staff and communicate with departments for daily quality improvement functions
• Review and analyze reports, records, and directives
• Confer with staff to obtain data such as new projects and problems encountered
• Verify data for government program requirements and ensure compliance
• Prepare reports for management on work function activities
• Evaluate current procedures and develop improved procedures
• Collaborate with appropriate departments for complaints and appeals resolution
• Monitor and analyze costs and participate in budget preparation

Manager, Quality Improvement – HEDIS

Clinical Operations

• Supervises and supports the implementation of clinical initiatives and/or programs to enhance care coordination, operational efficiency, and quality outcomes
• Oversees daily clinical operations and staff to ensure processes are executed consistently in alignment with NCQA standards, state regulations, and applicable contractual requirements
• Coordinates and supports clinical, quality, documentation, and data submission activities to support operational and quality objectives
• Reviews utilization, outcome, safety, and cost data and escalates identified trends or concerns to leadership for further action
• Monitors individual and team performance metrics, identifies performance gaps, and provides coaching or escalates concerns to leadership as appropriate to support operational and quality goals

Supervisor, Clinical Operations

• Oversee the implementation of the Ambetter Solutions ICHRA product in New York
• Ensure alignment with strategies and goals and consistency in implementation processes, methodology, and models
• Direct the creation and maintenance of standard models for the health plan implementation approach
• Serve as subject matter expert on the ICHRA NY operating model
• Actively collaborate with key stakeholders to develop the ICHRA NY product offering
• Provide leadership and oversight of the health plan business implementation processes
• Manage company adherence to standard implementation processes
• Direct the operating infrastructure to provide organization wide Project Management
• Provide input into operating models
• Direct health plan business implementations to meet budget, timeline and scope requirements

Director, Business Implementation

Backend Engineer

• Develops and operationalizes data pipelines to make data available for consumption (reports and advanced analytics)
• Engages with the DevSecOps Engineer during continuous integration and continuous deployment
• Designs and implements standardized data management procedures
• Designs, develops, implements, tests, documents, and operates large-scale, high-volume, high-performance data structures for business intelligence analytics
• Ensures quality of technical solutions as data moves across Centene’s environments
• Provides insight into the changing data environment, data processing, data storage, and utilization requirements
• Develops, constructs, tests, and maintains architectures using programming languages and tools
• Identifies ways to improve data reliability, efficiency, and quality

Data Engineer II – Snowflake, Python

Operations

• Ensure that the administration of the pharmacy program is accurate and compliant
• Support various operational tasks
• Answer team members' questions and provide support as needed
• Review benefit/formulary setup and testing
• Conduct data analysis to support operations
• Perform other duties as assigned
• Comply with all policies and standards

Pharmacy Operations Coordinator II

• Plan, manage and coordinate the analysis and configuration of claims information systems to meet business needs
• Oversee the configuration changes and design within core claims payment system
• Monitor production, backlog and accuracy of configuration
• Develop configuration tools and methodologies to enhance production of change requests
• Participate in planning, managing, analyzing, designing and implementing projects
• Break down problems, determine cause and provide a high-level solution to direct reports
• Evaluate programming techniques and training needs; select and implement training as needed

Manager, Claims Configuration – Business Analysis

People Operations

• Responsible for the analytical data needs of the business unit
• Handles complex data projects and acts as a lead for other Data Analysts
• Provide advanced analytical support for business operations across areas such as workforce and talent decision-making and external reporting
• Oversee production processes including creating of monthly close reporting for accounting
• Oversee the design and implementation of new software tools
• Oversee and review modifications of existing process of software
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources
• Frame ambiguous business and workforce questions into clear, decision-ready analytical approaches
• Review and translate complex business and workforce data into concise, actionable insights to determine operational impacts, needed actions, and emerging trends; elevate risks and opportunities to management
• Develop reports, analyses, and deliverables that inform leadership decision-making; present actionable recommendations inclusive of risks and tradeoffs
• Model data using MS Excel, Access, SQL, and/or other data warehouse analytical tools
• Partner across HR, analytics, and business teams to align on priorities and assist management in driving business decisions based on data
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis
• Oversee training and mentoring of other Data Analysts
• Determine workload and related activities for other Data Analysts
• Perform other duties as assigned
• Comply with all policies and standards.