Centene Jobs

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. Important Note: To be considered for this position, candidates must hold an ASA (Associate of the Society of Actuaries) designation, a bachelor's degree, and possess a minimum of two years of actuarial experience. Position Purpose: As a key member of our actuarial team, you will focus primarily on pricing Affordable Care Act (ACA) Marketplace plans. This role involves conducting in-depth actuarial analysis to accurately estimate financial outcomes and assess associated risks, considering the competitive and regulatory landscapes of the ACA market. In this Associate Actuary role, you will: Develop, analyze, and support optimizing pricing strategies for ACA Marketplace plans that consider the need for adequate premium rates and the competitive dynamics of a market Develop and review key pricing inputs and assumptions, including experience, reimbursement, and morbidity analyses Support the rate filing process in at least one state/market, including preparing rate filings and effective communication with federal and state regulators Serve as the main point of contact for all actuarial related activities for an assigned health plan Research and analyze the impact of various federal and state legislative/regulatory changes Analyze various data reports, identify trends and gaps and recommend action Why this role is appealing: This role offers a unique opportunity to shape the growth of Centene's Ambetter product and help maintain our leadership in the Marketplace. You'll be part of an actuarial team that values innovation, embraces advanced analytics, and empowers you to turn complex data into impactful pricing strategies. Education/Experience: Bachelor's degree in related field or equivalent experience. 2+ years of actuarial experience. License/Certification: Associate of the Society of Actuaries (ASA) (or equivalent international certification) In addition to the minimum requirements above, highly preferred skills: Advanced Excel skills Proficient in data querying and wrangling using tools such as SQL, R, SAS, or Power BI Preferred: 2+ years of ACA pricing experience, including rate filing submissions, or an equivalent background in pricing/rate setting for health insurance products Strong financial acumen with a solid understanding of actuarial and financial principles in a healthcare context Excellent communication skills with a proven ability to explain complex actuarial concepts to diverse audiences Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States. Due to the needs of the business, ideal work schedule is PST time zone is preferred, yet not required. Pay Range: $86,000.00 - $154,700.00 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

Become a part of our caring community and help us put health first The Field Care Manager, ARTS assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Field Care Manager, Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. POSITION RESPONSIBILITIES: Utilizes high-quality, evidence-based substance use services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical, behavioral health, and ARTS providers. Provides comprehensive, integrated support to members experiencing substance use and possible co-occurring conditions, including children, adolescents, adults, and justice-involved members. Engages members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination. Completes all required assessments, including the Comprehensive Risk Assessment (CHRA). Coordinates behavioral health, substance use, and medical services, ensuring appropriate provider engagement and adherence to treatment plans. Improves member's health literacy while simultaneously addressing health related social needs to positively impact member's healthcare outcomes and well-being. Serves as the quarterback of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery. Facilitates ICT meetings, ensuring seamless communication among providers, Service Coordinators, and Care Management Extenders. Engages in biannual and quarterly face-to-face visits, ensuring continuous monitoring and proactive intervention. Must be able to work with autonomy but reach out when support is needed. Collaborates with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members' preferences and needs. Will follow processes, and procedures to ensure compliance with regulatory requirements by the Virginia Department of Medical Assistance Services (DMAS), Center for Medicare and Medic Use your skills to make an impact REQUIRED QUALIFICATIONS Active LMHP License in the state of Virginia Minimum of 1 year of experience working directly with individuals with substance use disorder (SUD). Case management experience providing care transitions for ASAM levels of care and overall structured care management for members receiving VA Addiction and recovery services. Must reside in Virginia; This role will be regionally based in one of the Commonwealth's six regions: Central or Charlottesville Ability to travel to region-based facilities and homes for face-to-face assessments. Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport. Ability to work with minimal supervision within the role and scope. Ability to use a variety of electronic information applications/software programs including electronic medical records. Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel. Valid driver's license, car insurance, and reliable transportation. PREFERRED QUALIFICATIONS: Case Management Certification (CCM). Experience working with Medicare, Medicaid and dual-eligible populations. Field Case Management Experience. Experience working with pregnant and post-partum population with SUD, including Substance Exposed Infants. Knowledge of community health and social service agencies and additional community resources. Knowledge of ASAM levels of care. Managed Care Experience. Bilingual preferred (Spanish, Arabic, Vietnamese or other). Additional Information Workstyle: This is a remote position that will require you to travel. Travel: Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with staff, providers, members, and their families. Workdays and Hours: Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST). Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status . It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. Description Safeco sells insurance through more than 10,000 independent agents nationally and no two are exactly alike. The Agent Customer Service Representative provides support and ease of doing business for our independent agents through offering complete and accurate information while providing a superb experience. After attending our informative and interactive paid training program, you will become a subject matter expert in educating our agents on our innovative systems and services which allows them to promote quality growth for Safeco. Our Common Purpose is the guiding principle that exemplifies the way we behave at Liberty Mutual Insurance. It defines how we interact with our customers, agents, and each other to deliver the kind of exceptional customer experience that differentiates us from our competitors. The start date for this position is August 25th, 2025 Schedule is Monday - Friday no weekends Assigned schedule may be anytime between 8:00 am - 8:00 pm The work arrangement for this position is fully remote Responsibilities: * Delivers expertise by identifying and analyzing agent needs to offer solutions on Safeco products and services and provide education on self-service tools. * Research policy, coverage and eligibility provisions * Upholds our client care standards by achieving individual goals on call quality, handle time, adherence, first call resolution, and reliability * Maintains and tracks accurate data in various computer systems. Qualifications * Associates degree in a business-related field or equivalent training required. * Minimum of 6 months related work experience required; customer service experience or help desk preferred. * Ability to review, record and organize information from a variety of departments. * Excellent oral, written and interpersonal communication skills, and the capacity to multi-task in a structured work environment. * Ability to handle confidential and proprietary information. * Proficiency with computers is mandatory; Knowledge and ability to use Microsoft office. * Must have a clear understanding of the organization`s policies, standards and procedures to guide customer interactions. * Passing Proficiency Assessments is required. About Us As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally. At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow. We are proud to support a diverse, equitable and inclusive workplace, where all employees feel a sense of community, belonging and can do their best work. Our seven Employee Resource Groups (ERGs) offer a centralized, open space to bring employees and allies together to connect, learn and engage. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

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. The ideal candidate will have experience working with individuals facing homelessness, substance use issues, or serious mental illness (SMI). Key qualifications include familiarity with fair housing laws, community programs, and HUD-funded initiatives. HMIS (Homeless Management Information System) experience is a plus for this role. The position involves substantial travel, up to 75%, for community outreach and events in the following regions: Elko County Carson City, Douglas, Lyon, Storey, Churchill County Nye County - Pahrump Position Purpose: Responsible for supporting housing providers to comply with state and federal housing regulations and evidence based practices related to housing. Responsible for assessing the needs of homeless individuals and families and assisting with obtaining and maintaining permanent housing. Also works with the Housing Administrator to strengthen housing placement and retention efforts for members. This position is remote and works collaboratively with community partners, housing providers, internal care teams, and closed-loop referral systems to coordinate services, support housing placements, and contribute to the success and sustainability of housing initiatives. Additionally, this role will play an active part in supporting the implementation of Nevada Medicaid's upcoming In Lieu of Services (ILOS) for Housing Supports & Services. Collaborate with provider agencies to identify members qualified to receive housing Assist members in the housing application process and work with providers to ensure applications and supporting documentation are submitted timely Track and obtain available housing resources and implement the processes necessary to assist members with securing and maintaining housing and related services Maintain up to date housing database and document all services Coordinate with providers to verify members are transitioned to housing placement timely Implement housing tools to prioritize placements Collaborate with all involved agencies and organizations to facilitate the processing of housing applications. Assess the needs of resident families regarding housing and family stability to develop objectives and action steps for obtaining permanent housing Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in health care related field or equivalent experience. 3+ years experience in servicing adults with SMI or in a health care related field. Experience in non-profit housing services and understanding of Continuum of Care Permanent Supportive Housing and Transitional Housing Programs. Knowledge of fair housing, tenant's rights, and SAMHSA evidence based practices. Licenses/Certifications: Current state driver's license required. Pay Range: $55,100.00 - $99,000.00 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

Hybrid Schedule: Tuesday/Wednesday and a 3rd day of your choice onsite The Executive Assistant will provide administrative support to senior leadership within the Evernorth organization. This position will be critical in managing calendars, preparing for meeting, partnering with key stakeholders and coordinating projects. Essential Functions * Anticipate organizational needs and perform administrative functions * Manage leader calendars including scheduling and coordination of internal and external meeting invitations * Prepare and coordinate materials for meetings and presentations * Handle department invoicing process, coordinate with procurement and accounts payable * Schedule and manage leader travel and expense reporting process * Partner with stakeholders on project needs * Provide logistical support for department * Coordinate onboarding for new employees * Manipulate data and prepare reports using spreadsheets * Compose communications, memos and correspondence * Special projects as assigned Minimum Qualifications * HS Diploma or GED * 4-6 years of Experience * Strong organizational and time management skills * Excellent written and oral communication skills * Proficiency in Word, Excel and Power Point * Ability to work in a team environment * Ability to keep sensitive information confidential * Experience in Project Coordination If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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. ***Candidate must reside in the state of Florida. Must have four years or more of Pediatric experience and LPN licensure*** Position Purpose: Assesses, plans, implements, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination. Develops or contributes to the development of ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members in a timely manner May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans Identifies problems/barriers for care coordination and appropriate care management interventions for members with higher level of care needs Reviews referrals information and intake assessments to develop or assist in the development of appropriate care plan/service plan for members with higher level of care needs Collaborates with healthcare partners as appropriate to facilitate member care to ensure member needs are met and determine if care plan/service plan revision is needed Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators May perform on-site visits to assess member's needs and collaborate with providers or resources, as appropriate May provide education to care managers and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits Serves as a Subject Matter Expert (SME) to support the care navigation team and/or serve as a preceptor for newly hired staff Other duties or responsibilities as assigned by people leader to meet the member and/or business needs Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Requires a Bachelor's degree and 4 - 6 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. License/Certification: Current state's clinical license preferred For CMS Florida licensed practical nurse with a minimum of four years of pediatric experience, or a Master's degree in social work with a minimum of one year of related professional pediatric care experience. May require up to 80% local travel required Pay Range: $26.50 - $47.59 per hour 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

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. Position Purpose: Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and/or any other custom measurements. Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards Review medical records and abstract data for HEDIS and other measure sets in compliance with standards Track and report on issues and outcomes related to abstractions and over-reads Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required Perform other quality initiatives as necessary Education/Experience: Associate's degree in related field or equivalent experience. Bachelor degree preferred. 4+ years of nursing, medical assistant, medical coding or data management experience. Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) preferred. Advanced knowledge of Microsoft Applications, including Excel and Access. Licenses/Certifications: Current state's RN or LPN license preferred.Pay Range: $26.50 - $47.59 per hour 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

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. Must reside within the Tempe or Tucson, Arizona area. Day shift Arizona Time Zone. Position Purpose: Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits. Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plans Develops in-depth knowledge of care management services including responding to some complex or escalated issues Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care Performs service assessments/screening for members with some complex needs and documents the member's care needs. Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed Works with care management team with triaging, adjusting, and escalating complex requests to management Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards Ability to identify needs and make referrals to Care Manager, community cased organizations, and Disease Manager Provide education on benefits and resources available May assist with training and development needs Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a High School diploma or GED Requires 2 - 4 years of related experience Pay Range: $20.00 - $34.03 per hour 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. 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

The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. Description The Global Cyber Claims Operations Manager will work closely with the Global Cyber Claims Leader (GCCL) and Liberty Internal Insurance (LII) regional Cyber Claim Professionals to deliver consistency in claims handling across the (7) GRS regions including: North America Specialty (NAS) US, NAS Bermuda, LM Canada, LII London, LII Central, LII East, and LII West. The Global Cyber Claims Operations Manager leads the assessment, design, build, implementation and measurement of best practices, claims process integrity audits, initiatives, and portfolios of work of moderate to high complexity across several global claim regions. In this role, you will look broadly across global geographical regions and Profit Centers and the marketplace to identify opportunities for improvement in Cyber Claims handling. Additionally, the Global Cyber Claims Operations Manager owns engagement /collaboration with stakeholders to improve and maintain solutions and anticipates depth and frequency of necessary communications, and participates in ongoing planning/prioritization of work. In focus for 2025-2026 are efforts that may include our Data Integrity Processes and strategy, claim reserving integrity processes and strategy, Optimization (e.g. ensuring the right work to the right resources), Build Our Brand (ensuring we're effectively communicating our value internally and externally), Connectivity with our partners in Actuarial, Underwriting, Risk Engineering Cyber Incident Response vendor management, and local senior claims management, as well as additional initiatives focused on continually improving the value our NAS Claims teams provide to our customers and brokers. The role can be located within any of the 7 GRS Global Cyber Claims Operation Regions. This role will have an in-office work requirement if located within a 50-mile radius of a GRS Claims office. There will be occasional business travel. Responsibilities: * Serves as lead on most projects/leads the management of portfolios of work. * Project Management scope, build, and execute on complex project plans with understanding of critical paths, milestones, and risks. * Works on intermediate to advanced level complexity work. * Demonstrated ability to rapidly absorb, synthesize, and embed technical concepts of higher complexity across Global Cyber Claims and partner organizations (e.g., Underwriting, Risk Engineering, Legal & Actuarial). * Works closely with Claims Enablement and Global Cyber Claims Lead and Product Owner to ensure that claims professionals' needs from a systems perspective are being met. * Works closely with Claims Enablement and Global Cyber Claims Lead and regional Cyber claims representatives to develop global Cyber claims handling best practices. * Serves as lead/co-lead on projects involving operations, systems and streamlining claim professionals' work. * Designing and implementing focus audits for claim coding and reserving initiatives * Serves as a thought leader on technical concepts and on the identification of opportunities for continuous improvement. * Demonstrates advanced level root cause problem solving skills. * Intermediate and advanced use/understanding of analytics and data to form arguments, assess opportunities, measure impact. * Assess employee training and development needs and offers recommendations to meet needs. * Facilitates training workshops and programs. * Monitors expenses in relation to budget on ULAE and ALAE issues. * Participates on various internal and external committees and ensures senior management is kept up-to-date on activities. * Handles special projects and initiatives as assigned which may include in-depth research and analysis in order to assess a problem and/or offer a solution to meet a need. Works closely with Business Market admin, Sales, Underwriting and Loss Prevention. * Collaborates closely with Underwriting, Risk Engineering, and Data Science functions to ensure that claim data and expertise and properly integrated into those functions. And at times, serve as a claim subject-matter expert on projects or initiatives run by those other functions. Qualifications * Excellent organizational skills to coordinate activities and programs. * Demonstrated ability to communicate verbally and in writing at all levels of the organization and clearly and concisely express opinions, conclusions and recommendations. * Solid knowledge of theories and practices within the Claims field operations; knowledge of Claims management practices, Company operations and applicable policies. * 7-10 years of relevant and progressively more responsible related work experience required, Bachelor`s Degree preferred * Advanced insurance related designations/CPCU preferred About Us As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally. At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow. We are proud to support a diverse, equitable and inclusive workplace, where all employees feel a sense of community, belonging and can do their best work. Our seven Employee Resource Groups (ERGs) offer a centralized, open space to bring employees and allies together to connect, learn and engage. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

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. ***This position is remote with minimal travel required. Candidates can reside anywhere in the United States, but must be licensed in the State of Texas and willing to work in the Central Time Zone. Experience with ABA, Psychological Testing, Neuropsychological Testing required. Utilization Management experience strongly preferred. *** Position Purpose: Authorize, direct and monitor care for behavioral health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care Conduct peer reviews with psychologist and licensed therapist/certified Behavior Analyst for outpatient and/or psychological testing requests Interact with network practitioners to provide education on best practice models and utilization management processes Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD Facilitate outpatient rounds offering clinical input and oversight related to outpatient services Performs other duties as assigned Complies with all policies and standards Education/Experience: PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required 2+ years Behavioral Health required Working Knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence based practices required PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required or Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire required Additional Information: Fully remote position with travel to Austin, TX required once per year Must be willing to work in the Central Time Zone TX licensure required Utilization Management (UM) experience strongly preferred Pay Range: $86,000.00 - $154,700.00 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

Pay Philosophy The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. Description As a part of our construction product offerings and portfolio, Liberty Mutual is hiring a Subcontract Default Insurance (SDI) Underwriter to join our team. The SDI Underwriter will work in support of the Underwriting Team in analyzing and managing new and existing SDI accounts of all sizes and complexities, in support of SDI's national strategy. SDI is a growing team within Liberty Mutual Surety. Liberty Mutual Surety, a business unit of Liberty Mutual Insurance, is the world's largest globally Surety, including in the United States. Conducting business worldwide through fronting relationships and Liberty-owned subsidiaries, we provide bonds in over 60 countries for construction firms, manufacturers and suppliers, and commercial enterprises on an account and transactional basis. We are committed to building mutually profitable relationships by providing smart business solutions, ease of doing business, and consistent, responsive service. Liberty Mutual Surety is dedicated to the communities we serve and highly values a diverse workforce in more than 18 countries. Responsibilities: Review and analysis of financial, capacity, and operational systems and controls in conjunction with current SDI practices. Help execute the SDI vision and value proposition that recognizes changing business and competitive environment dynamics, key business drivers, and financial elements. Leverage strong United States and Canadian broker relationships to effectively promote and represent Liberty Mutual with customers and at industry events. Support and execute SDI business strategy to successfully propel the product and client segments into a significant, profitable, sustainable, and long-term marketplace leadership position. Develop, leverage, and maintain internal and external stakeholder relationships. Assist with new product development, implementation, and oversight; actively engage with others in the Liberty Mutual suite of construction surety and insurance offerings as well as collaborate with other underwriters, claims, and actuarial teams to share insights and best practices across the organization. Utilizing data, analytics, and technology to improve Underwriting risk selection and portfolio management. Special projects as assigned. Experience in the construction industry is highly preferred! Qualifications Bachelor's Degree in Finance, Construction Management, Accounting, Risk Management and Insurance or business related field typically required. A minimum of 3 years experience preferably in the construction industry. Analytical ability and decision-making skills Demonstrated ability to make and clearly communicate sound recommendations that includes complex analyses, both verbal and written Displays strong interpersonal skills in dealing with internal and external stakeholders, including leading presentations with senior leadership. About Us As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally. At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow. We are proud to support a diverse, equitable and inclusive workplace, where all employees feel a sense of community, belonging and can do their best work. Our seven Employee Resource Groups (ERGs) offer a centralized, open space to bring employees and allies together to connect, learn and engage. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

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. Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits. Shift will be 12:00pm - 9:00pm EST Obtain and verify insurance eligibility for services provided and document complete information in system Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies Collect any clinical information such as lab values, diagnosis codes, etc. Determine patient's financial responsibilities as stated by insurance Configure coordination of benefits information on every referral Ensure assignment of benefits are obtained and on file for Medicare claims Bill insurance companies for therapies provided Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs Handle inbound calls from patients, physician offices, and/or insurance companies Resolve claim rejections for eligibility, coverage, and other issues Performs other duties as assigned Complies with all policies and standards Education/Experience: High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor's degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Pay Range: $15.58 - $26.73 per hour 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. 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

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. Pharmacy Technician, Clinical Services - Call Center - MTM & Pharmacy Adherence - 11am - 8pm (In your own time zone) M-F - Remote Position Purpose: Supports the efforts of the clinical team through collaboration with prescribers and targeted beneficiaries in order to ensure appropriate, evidence-based drug selection and resolve medication-related problems. Engages in drug utilization review (DUR) by supporting the execution of DUR initiatives via meeting preparation, letter campaigns, and telephonic outreach to members/providers. Supports basic data analytic activities and tracking of interventions, and assists with preparation and documentation of responses to regulatory audits associated with the over utilization program. Provides medication therapy management (MTM) services via triage of inbound calls to the MTM hotline, monitors fax line for prescriber responses and completion of failed faxes, supports the pharmacist for completion of Comprehensive Medication Reviews (CMRs) through pre-work up and case preparation, communicates with network pharmacies, prescribers, and beneficiaries to provide MTM services. Engages in quality improvement projects including supporting the execution of prescriber mailings and tracking and maintaining physician and member responses regarding pharmacy quality outreach campaigns. Documents and records services/activities in appropriate databases/software to ensure compliance with CMS requirements for clinical service offerings assigned in designated area (i.e. MTM services, Quality Improvement Projects, DUR, etc.). Serve as backup for technicians in the other clinical service departments (Drug Utilization Review, Medication Therapy Management, Quality Improvement). Performs other duties as assigned. Education/Experience: High School or GED required. 0-1 year of experience in pharmacy operations managed care, hospitals, and/or retail environments Licenses and Certifications: Certified Pharmacy Technician (CPhT), preferred Bilingual - Fluent English & Spanish or other language, highly preferred. Training: 10am - 7pm Monday - Friday (Eastern / EST) for first 2 weeks & 2 days. Working Shift after training: 11am - 8pm Monday - Friday (In your own time zone) - No exceptions. This is a work from home Pharmacy Technician, Call Center position. The main function is telephonic outreach to our members to complete medication reviews (MTM's) and for Pharmacy Adherence. Pay Range: $15.57 - $26.20 per hour 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. 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

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. Remote position - centralized to Fresno/Sacramento CA Position Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks. Perform duties to support the development, coordination and maintenance of the pharmacy program. Conduct UAT and data analysis to aid in the development, coordination and maintenance of the pharmacy program. Serve as the subject matter expert supporting various pharmacy operations tasks including but not limited to claims, formulary, benefit, and networks. Performs other duties as assigned Complies with all policies and standards Education/Experience: High School Diploma or GED, Associate's Degree preferred, and 3+ years of pharmacy experience, preferably in managed care environment. Government sponsored program (Medicare and/or Medicaid) experience preferred. License/Certification: Current state's Pharmacy Technician license preferred Preferred Qualifications: Experience in working with pharmacy claims data with an understanding of key pricing elements Proficiency in Excel; Access a plus Ability to conduct data analysis to support network operations and exercise Pay Range: $26.50 - $47.59 per hour 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. 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

You could be the one who changes everything for our 28 million members as an Intern at Centene. During this 12-week program, you'll learn more about Centene and how we're transforming the health of the community, one person at a time. Observe preceptors and participate in various projects to learn and develop skills related to the Managed Care industry. Develop clinical knowledge and skills by learning about various processes and functions within the Managed Care industry Observe processes and shadow preceptors to gain hands on experience and become familiar with various clinical services Follow instructions and procedures provided by preceptor or manager in accordance with company guidelines Education/Experience: Current enrollment in an accredited clinical program. Candidates must be receiving course credit for participating in the Externship program. Unpaid. Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) 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. 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

We are seeking a detail-oriented and customer- focused Collections Specialist to join our Accounts Receivable team in a fast-paced specialty distribution environment. This role is responsible for managing a portfolio of business-to-business (B2B) accounts, resolving billing issues, and driving timely payments while maintaining strong client relationships. The ideal candidate will have experience in B2B collections, particularly in healthcare, pharmaceutical, or specialty distribution industries. ESSENTIAL FUNCTIONS * Manage a portfolio of B2B customer accounts to ensure timely collection of receivables. * Proactively contact business clients via phone, email, and customer portals to resolve past-due balances. * Research and resolve payment discrepancies, short-pays, and disputes in coordination with internal teams (Sales, Customer Service, Billing, Cash, et..) * Monitor aging reports and prioritize collection efforts based on risk, balance, and payment trends. * Maintain accurate collection notes, status updates, and documentation in the ERP system. * Escalate high-risk accounts or unresolved issues to leadership in a timely manner. * Contribute to continuous process improvement initiatives for the collections workflow. * Schedule and lead customer-facing WebEx meetings to review aging, payment trends, and open issues. * Send out account statements in Excel format on a regular basis and support customer inquiries related to those statements. QUALIFICATIONS * 2+ years of experience in B2B collections or accounts receivable; industry experience ins specialty distribution, healthcare or pharmaceuticals strongly preferred. * Proficient in Microsoft Excel, including preparing and formatting customer-facing statements (VLOOKUPs, pivots tables a plus). * Comfortable leading virtual meetings with customer and internal teams. * Working knowledge of SAP. * Excellent communication and negotiation skills, with professional and customer-focused demeanor. * Ability to work independently, manage multiple priorities, and meet deadlines. * High attention to detail and problem-solving skills. WORK HOURS * Employee must be available to work between 10:00AM EST-7:00PM If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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. Position Purpose: Implement development activities for the recruitment, contracting and retention of providers. Negotiate contracts and develop strategies and methodologies for specific network development initiatives. Monitor business processes related to provider contracting to determine their efficiency and protective value, and assure integrity of records, information and systems in compliance with Company policies/standards and government regulations. Prepare provider contracts and monitor process to ensure timely execution of contracts. Manage fee schedules, ensuring timely and accurate loading in company IS system. Monitor and oversee provider contract compliance and issue corrective action letters for non -compliance. Conduct and oversee administrative audits of provider agencies. Prepare and analyze reports and records on functional area and on organizational activities, recommend improvements for upper management. Monitor operational and financial performance of agreements using results to guide future negotiations. Meet individually with providers to develop long-term relationships and resolve operational issues. Review redline contract language and provide accept/decline recommendations to management. Travel up to 50% for provider meetings and team meetings Education/Experience: Bachelor's degree in related field or equivalent experience. Master's degree preferred. 5+ years of contracting, network development and/or provider relations experience. Project management experience. Experience in a healthcare or insurance environment, preferably in Medicaid. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff. This position is remote within the State of New Jersey. Candidates must reside in the state of New Jersey to be considered. Travel up to 50% for provider meetings and team meetings required. Home office located in Iselin, NJ. Pay Range: $86,000.00 - $154,700.00 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

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. * Qualified candidates must reside in the state of Pennsylvania* Position Purpose: Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk Adjustment vendors for programs within all lines of business. Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in vendor management related to those initiatives Help train providers and Health Plan staff in Risk Adjustment methodologies and activities to continue to improve Centene's Risk Adjustment score - some travel maybe required Research and assist in development of best practices into operations for Risk Adjustment Prepare operational workflows specific to each product business requirements and the local market dynamics Prepare and participate in meetings with various committees and providers Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree or equivalent experience. 2 years of quality improvement or clinical experience required. Bachelor's degree in nursing and experience in managed care industry preferred. Risk adjustment and Microsoft Excel experience preferred. Up to 10% in-state travel required. Pay Range: $55,100.00 - $99,000.00 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

Coordinates and supports the billing functions for assigned clinicians, across multiple practices and specialties. Works with the RCM vendor partner on daily revenue specific job functions, budget targets and all other responsibilities as assigned job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner. **********