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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.

***POSITION IS REMOTE***

***MUST HAVE RN LICENSE***

**Position Purpose:** This position will work with internal and external customers as well as within the Performance Delivery Team (PDT) to assist in successfully driving performance improvement for assigned Value Based Provider Group partners and identify potential future partners. To accomplish this, the position is responsible for all necessary clinical analysis related to the successful management of the Value Based Provider Group partners. Candidate Education: Required A Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field

+ Lead all clinical analysis in support of the successful performance improvement activities related to the assigned Value Based Provider Group partners and communicate potential clinical implications of findings.

+ Build collaborative relationships with internal and external customers to facilitate process improvement and improved clinical outcomes.

+ Assist in the development of new Value Based Program models to meet business needs.

+ Assist in ensuring all Value Based Program reporting is being delivered to assigned Value Based Provider Groups.

+ Assist in the development and execution of Value Based Provider Group business plans.

+ Participate in internal and external Business Planning and Core Team meetings

+ Lead all clinical/quality discussions on behalf of the PDT.

+ Assist in ensuring all Value Based Program contract requirements are achieved.

+ Assist in the development of an annual Value Based Provider Group prospective partner list.

+ Work in accordance with corporate NSP team to develop and improve departmental processes and procedures.

+ Assist in identifying and analyzing requests for proposals and assist in successful responses for Meridian Health Plan, Meridian Advantage and MeridianRx.

+ Assist in Prospecting and generating leads of potential providers.

+ Assure compliance with requirements of all national and State regulatory agencies, including NCQA, URAC, CMS or general accreditation.

+ Assist in special projects assigned by the PDT Manager or Executive Team.

+ Perform other duties as assigned.Additional Responsibilities:

**Preferred A Master's Degree in a related field Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related fieldCandidate Experience:** Required 3+ years of experience in clinical setting

Required 2+ years of experience in Managed health care industry

Required Other Basic knowledge of Value Based Program:

**Required Other Thorough knowledge Medicare and Medicaid quality scoring methodologies including HEDIS, NCQA and Pay-for-Performance Measures:** Required Other Thorough knowledge of CMC's mission and its operational structures

Required Other Basic knowledge of CMC's provider policies and procedures

**Required Other Excellent knowledge of medical terminology Licenses and Certifications:** A license in one of the following is required: Required Registered Nurse (RN)Pay Range: $68,700.00 - $123,700.00 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, 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