Jobs at Centene Corporation

Lead operations and business strategy across cross-functional teams, perform data analysis to measure program effectiveness, drive process improvements using quality methodologies, support staff in achieving strategic initiatives, and oversee quality monitoring and auditing with up to 25% travel.

Lead analytics for Internal Audit Claims: extract, transform, reconcile, and validate large claims datasets; build and maintain Power BI reports/dashboards; perform QA and tie-outs; support automation, bots/AI enablement, and executive reporting; mentor other analysts and partner with audit, IT, and business stakeholders to deliver repeatable, validated analytics.

Remote psychologist reviewer authorizes and monitors behavioral health/ABA care, conducts peer reviews, provides clinician education on best practices and utilization management, responds to complaints, collaborates with Medical Director, and offers clinical oversight for outpatient services.

12-week clinical externship observing preceptors and participating in managed care projects. Learn clinical processes and services, follow preceptor guidance, gain hands-on experience, and develop managed care-related clinical skills while receiving course credit.

Supervise utilization management nursing team handling prior authorization, concurrent and retrospective reviews. Ensure compliance with regulations and quality standards, coach and evaluate staff, lead process improvements, assist hiring and training, and collaborate with senior management on UM policies and complex member care issues.

The Senior Business Systems Analyst collaborates with stakeholders to translate business requirements into technical specifications, manages requirements throughout the project lifecycle, and ensures alignment with organizational goals while enhancing efficiency in processes.

The Senior Business Systems Analyst collaborates with stakeholders to translate complex requirements into technical specifications, ensuring alignment with strategic goals. Responsibilities include gathering business requirements, creating process models, managing project lifecycles, and providing user support.

Act as a liaison to improve pharmacy quality performance, collaborating with providers and pharmacies, and ensuring timely insights while managing territory engagement plans.

Lead and conduct enterprise-wide compliance and ethics investigations across business units and health plans. Assess allegations, review documents, interview witnesses, prepare investigation reports, recommend remediation or discipline, track corrective actions, maintain case files in centralized systems, produce metrics and presentations, and collaborate with cross-functional stakeholders to ensure regulatory defensibility.

Lead pharmacy operations across multiple markets and products, develop and implement pharmacy benefit management programs, manage vendor contracts and accreditation participation, analyze utilization and financial data, oversee pharmacy staff, and support provider education and budget planning to achieve organizational pharmacy and medical goals.