Centene Corp

Director, LTSS Clinical Care Management

Centene Corp • $127K — $236K *
US-AnywhereRemote in Indiana, US
Healthcare
5 - 7 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Graduate from an Accredited School of Nursing or a Bachelor's degree with 7+ years of experience including management roles.
  • Master's degree or RN with 7+ years of related experience for Behavioral Health team oversight.
  • 4+ years of management experience preferred.
  • Expert knowledge of industry regulations, policies, and standards preferred.
  • Strong knowledge of healthcare managed care principles and clinical assessment methods preferred.

Responsibilities

  • Lead the development and improvement of the long-term care management process.
  • Set and oversee goals for the long-term care management team.
  • Ensure compliance with corporate and regulatory standards in care management policies.
  • Monitor staff assignments and member caseloads based on needs and regulations.
  • Review and sign off on contract-required reporting for quality assurance.
  • Attend industry conferences to stay informed on healthcare trends.
  • Provide coaching to enhance the member and provider experience.

Benefits

  • Comprehensive health insurance coverage.
  • 401K and stock purchase plans.
  • Tuition reimbursement for continuing education.
  • Paid time off plus recognized holidays.
  • Flexible work options including remote, hybrid, field, or office settings.
Full Job Description
Candidate must reside in Indiana or be willing to relocate to Indiana.
Serves as the LTSS subject matter expert, leading RFP development and submissions while supporting the design, implementation, and growth of LTSS programs.

Position Purpose: Directs the long-term care of members with physical/medical health needs and/or behavioral/mental health needs to develop and assess high quality, cost-effective healthcare outcomes. Develops strategies and objectives within long-term care management to improve member and/or provider experience.

  • Provides leadership to the development, implementation, monitoring, and ongoing improvement of the long-term care management process
  • Sets goals and objectives for long-term care management team and oversees care management data and reporting metrics to achieve quality and cost-effective healthcare results and working with senior leadership, as required
  • Leads 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
  • 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
  • Attends conferences and stays up to date on latest trends and best practices in Payer Care Management and related fields, as applicable
  • Leads and presents process improvements for the long-term care management team to achieve cost-effective healthcare results
  • Leads and coordinates large or special project work with other departmental functions
  • Directs and evaluates departmental operations, including the long-term care management model, staffing, use of information technologies, onboarding, and staff competencies to achieve performance and quality objectives
  • 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
  • Contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care
  • Develops long-term care management strategies and influences decisions by providing recommendations that align to organizational objectives
  • Provides coaching and guidance to long-term care management team to improve member and provider experience and facilitate delivery of high-quality care
  • Develops department budget while collaborating inter-departmentally and with senior leadership
  • Develops the overall strategy for onboarding, hiring, and training new long-term care management team members to ensure adequate training and high-quality care to improve member and/or provider experience and ensure compliance
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Positions overseeing RN team members: Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 7+ years of related experience, including prior management experience. Or,
Positions overseeing BH team members: Requires a Master's degree or Graduate from an Accredited School of Nursing and 7+ 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.

4+ years management experience preferred.
Expert knowledge of industry regulations, policies, and standards preferred.
Highly advanced clinical knowledge and ability to assess member needs in context of relevant diagnoses, treatment plans and goals, and identify potential gaps in care or risks for readmission or complications preferred.
Strong knowledge of healthcare managed care principles preferred.
Experience working with providers and healthcare teams to develop appropriate long-term service plans/care plans preferred.
Strong knowledge of medication indications and side effects preferred.

License/Certification:

  • Positions overseeing RN team members: Current state’s Registered Nurse (RN) license required preferred or
  • Positions overseeing BH team members: Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required preferred

Pay Range: $127,300.00 - $236,100.00 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.

About Centene Corp

Centene Corporation is a managed healthcare enterprise at the forefront of innovation and growth for government-sponsored and commercial healthcare, providing access to fully integrated, high-quality, and cost-effective services that help people lead healthier lives. The company’s local approach addresses the needs of under-insured and uninsured individuals who often lack the resources required to sustain optimal health and wellness. Centene began as a single health plan in Milwaukee, Wisconsin in 1984. After an initial period of growth, Michael Neidorff joined as President and Chief Executive Officer (CEO) in 1996, moving Centene’s headquarters to St. Louis, Missouri, where it still resides today. In the decades since its humble beginnings, Centene has transformed into a publicly-traded Fortune 500 company serving communities across the United States. In fact, Centene provides coverage in all 50 U.S. states. More than 26 million Americans rely on Centene to access a wide range of insurance solutions, including Medicaid, Medicare, TRICARE, correctional, and behavioral health services. Centene prioritizes the development of technology that addresses systemic conditions impacting the whole health needs of underserved populations. As technology plays an increasingly critical role in diagnosing, managing, and treating disease, Centene understands that it enables better health outcomes for members, lessening the burden for providers, and allowing more automation and efficiency for business operations. As a steward of a significant set of data and insights, Centene leverages this data to not only shape but lead the digital transformation of healthcare and improve the patient-provider experience. Centene’s current CEO, Sarah London, and her team are leading the charge in this new age. Sarah London worked within Centene’s Technology Innovation and Modernization division, spearheading the company’s enterprise-wide technology strategy. Now leading Centene, her focus is on building the next generation of products and services and establishing Centene’s long-term growth and value creation. Although Centene has grown into the No. 1 insurer in the U.S. Health Insurance Marketplace, it has never lost its focus on the individual or its passion for community health. Remaining connected to the individuals and families that need care most is central to Centene’s commitment to shaping a better world of healthcare for the communities it serves. Centene also remains connected to the needs of its employees, who make Centene what it is. Through its commitment to diversity, equity, and inclusion practices, Centene promotes a safe and inviting environment above all. Because of Centene’s commitment to excellence and progression in the healthcare industry, it has been recognized as a Top Organization for Diversity by Modern Healthcare magazine, a Leading Disability Employer by the National Organization on Disability, a Best Place to Work for LGBTQ Equality by The Human Rights Campaign Foundation, and a global leader by Bloomberg’s Gender-Equality Index, among many other recognitions. Centene was also named a Top 50 Company for Diversity by DiversityInc and a Top Veteran-Friendly Company by U.S. Veterans Magazine. It has also been listed on FORTUNE® magazine's list of the World's Most Admired Companies for several consecutive years.

Centene Corp Careers

Join the dynamic team at Centene Corp, a leader in the healthcare industry, where your career growth and development are prioritized. At Centene Corp, we offer a range of job opportunities that allow you to make a significant impact on our community and beyond.

Explore a World of Opportunities

Discover the diverse career paths available at Centene Corp, from healthcare services to innovative program development. Our job opportunities span various professional fields, offering positions that cater to your unique skills and ambitions. Whether you're looking for an entry-level role or a senior leadership position, Centene Corp is committed to hiring top talent and fostering a culture of excellence.

Innovation and Leadership at Centene Corp

At Centene Corp, innovation and leadership go hand in hand. We empower our team members to lead with confidence and creativity, driving the company forward through strategic innovation and robust leadership. Our leadership programs are designed to cultivate your skills, helping you to thrive as a professional and make meaningful contributions to our company and the communities we serve.

Internships and Early Career Programs

Kickstart your career with Centene Corp through our internship and early career programs. These opportunities provide hands-on experience and a glimpse into the dynamic world of healthcare management. Internships at Centene Corp are a stepping stone to full-time employment, offering invaluable networking opportunities, mentorship, and the chance to develop your resume and interview skills in a real-world setting.

Commitment to Diversity and Inclusive Culture

Centene Corp is dedicated to maintaining a diverse and inclusive work environment. We believe that diversity fuels innovation and enhances our team's performance. Our diversity training ensures that all team members appreciate and leverage the broad range of experiences and perspectives that each individual brings to the company.

Benefits and Employee Growth

We value our employees' well-being and career aspirations. Centene Corp offers competitive benefits, including health insurance, retirement plans, and professional development programs. Our commitment to your growth is reflected in our continuous learning initiatives and performance management processes that help you achieve your career goals.

Join Our Team

Are you ready to advance your career at Centene Corp? Explore our current job openings and find the position that best matches your skills and interests. We are looking for passionate, curious, and solution-driven team players who are ready to make a difference.

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SEARCH CENTENE JOBS

Centene Corp is not just a company—it's a place where you can shape your future and impact the lives of millions. Join us in our mission to transform the health of the community, one person at a time.
Learn more about Centene Corp
Size
72,500 employees
Market Cap
$46.5 billion
Industry
Healthcare
Net Income
$1.8 billion
Founded
1984
5 Year Trend
+25.4%
Revenue
$111.1 billion
NASDAQ
CNC
* Ladders Estimates

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