Centene Remote jobs - 1,165 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. Supports Long Term Services & Support (LTSS) network providers with recruitment and retention of direct care staff. Promotes self-determination and self-direction options with our membership. Partners with LTSS providers and account management to monitor staffing levels and engage providers and offer assistance with staffing gaps when indicated Conducts virtual and in-person job fairs to assist with recruitment Develops and maintains collaborative partnerships with local colleges and universities, the state workforce commission, agency networks and community groups Provides assistance to members through the following methods: Education and assistance with accessing Employment Assistance and Supported Employment benefits Referrals to the workforce commission and community organizations that link members to employment opportunities Provides support for individuals who self-direct, assist with back-up plan development (as needed) and provide webinars and forums on self-direction Monitors and expands alternative payment models with LTSS providers to provide financial incentive paid to direct care staff for high quality work Education/Experience: Bachelor's degree in Human Resources, Health Care, Sociology or related field or equivalent experience. 3+ years of related, employment specialist, workforce development, job coach, HR, client services, community relations, preferably in a managed care or Medicaid environment or other related experience. Community Health Worker Certification preferred. Candidates must be in one of the following Texas counties to be considered for this role: McMullen County, Texas, Jim Hogg County, Texas, Zapata County, Texas, Duval County, Texas, Maverick County, Texas, Webb County, Texas . This is a remote role that requires occasional local travel for internal and provider/member-facing meetings. Pay Range: $27.02 - $48.55 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

A leading health care company is seeking a Legal Counsel to join its Operations and Experience Legal team. This role involves providing legal advice and counsel on regulatory requirements in the health care industry. Candidates must possess a Juris Doctorate degree and an active law license in at least one US jurisdiction, with a minimum of 6 years of legal experience, including health plan expertise. The position offers the flexibility to work remotely from anywhere in the U.S. #J-18808-Ljbffr

Home Infusion Registered Nurse - Accredo Specialty Pharmacy Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services. We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes. As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications. However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care. You'll work independently, making decisions that lead to the best outcomes for your patients. You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team. For more than 30 years, Accredo has delivered dedicated, first-class care and services for patients. We partner closely with prescribers, payers, and specialty manufacturers. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on the lives of others. How you'll make a difference and improve lives: Empower Patients: Focus on the overall well-being of your patients. Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health. Administer Medications: Take full responsibility for administering IV infusion medications in patients' homes. Provide follow-up care and manage responses to ensure their well-being. Stay Connected: Be the main point of contact for updates on patient status. Document all interactions, including assessments, treatments, and progress, to keep track of their journey. Requirements: Active RN license in the state where you'll be working and living 2+ years of RN experience 1+ year of experience in critical care, acute care, or home healthcare Strong skills in IV insertion Valid driver's license Willingness to travel to patients' homes within a large geographic region Ability to work 32 hours a week (can include days, evenings, and weekends, per business need) Flexibility to work different shifts on short notice and be available for on-call visits as needed 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: ...@cigna.com for support. Do not email ...@cigna.com 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.

The job profile for this position is Chief Quality & Health Advocacy Officer, which is a Band 6 Executive Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Flexible Onsite Location: Bloomfield, CT, St, Louis, MO, Philadelphia, PA, other locations where The Cigna Group has an office presence. Position Summary The Chief Clinical Quality Officer (CCQO) at The Cigna Group is responsible for overseeing the quality and safety of healthcare services, ensuring the delivery of safe, effective, and patient-centered care while aligning quality initiatives with the company's strategic goals and operational excellence. This role will lead a cross-functional team of clinical and business leaders to build solutions, processes and functions that ensure a high degree of clinical integrity, quality and safety. The CCQO will work closely with the CMOs, policy teams, safety infrastructure, compliance and legal teams, and technology teams to drive quality improvement initiatives, leverage data analytics and reporting, and enhance patient outcomes and satisfaction. Key Responsibilities Quality Management: Develop and implement quality improvement and outcome strategies aligned with organizational goals. Collaborate with stakeholders to set and monitor key performance indicators (KPIs) related to healthcare quality and outcomes. Oversee quality assurance programs to ensure compliance with local, state, and federal regulation and with healthcare quality standards, including HIPAA, JCAHO, and CMS as well as HEDIS, NCQA Health Plan Ratings, STARS, and CAHPS compliance. Identify and mitigate risks related to healthcare quality and implement continuous improvement methodologies like Six Sigma or Lean Healthcare. Clinical Safety Oversight: Lead the development and implementation of a robust clinical safety framework across all care and health services delivery settings. Oversee incident reporting systems, root cause analyses (RCA), and failure mode and effects analyses (FMEA) to proactively identify and mitigate risks. Establish and monitor clinical safety KPIs, including adverse event rates, sentinel events, and near misses. Collaborate closely with legal, compliance and FWA teams. Ensure timely investigation and resolution of safety events, with transparent reporting to leadership and regulatory bodies. Collaborate with clinical leaders to embed evidence-based safety protocols and promote a culture of high reliability. Champion infection prevention and control programs, medication safety initiatives, and patient harm reduction strategies. Leadership & Team Management: Collaborate with stakeholders to develop business cases and monitor performance. Lead and develop a multidisciplinary team focused on clinical excellence, quality and safety. Foster a culture of continuous improvement and innovation. Represent the department in executive meetings and external forums. Stakeholder Engagement & Collaboration: Collaborate with internal entities, healthcare providers, and members/patients to improve quality and integration of interventions. Engage with industry experts and participate in relevant forums and committees. Required Qualifications MD or DO with board certification. 15+ years of leadership experience in a large healthcare organization, including 5+ years in direct leadership of patient experience and quality improvement. Strong knowledge of healthcare quality standards and patient experience strategies. Excellent leadership skills, strategic thinking, and ability to execute for results in a complex commercial environment. Proven ability to innovate and drive organizational change. Experience in a highly matrixed organization with strong internal enterprise relations. Strong communication skills, with the ability to translate complex topics into consumable formats. Key Competencies Strategic Mindset Builds Networks Manages Conflict Organizational Savvy Courage Drives Vision and Purpose Persuades Cultivates Innovation Situational Adaptability Ensures Accountability Resourcefulness 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. 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. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. #J-18808-Ljbffr

A leading health services company is seeking a Risk Management Lead responsible for oversight of risk adjustment operations. The role includes advising on risk management strategies, compliance, and project management. The ideal candidate should have significant experience in project leadership and risk analysis, with a passion for enhancing consumer experiences. This remote position requires strong initiative and the ability to manage multiple projects simultaneously. Interested candidates are encouraged to apply for a rewarding opportunity focused on health improvement. #J-18808-Ljbffr

A healthcare services company is seeking an Actuary for Analytics/Forecasting to analyze financial data and support strategic decisions. This role offers upward mobility and exposure to senior leadership. Candidates must have strong communication skills and experience across multiple functions like modeling and pricing. The position is remote with occasional travel, and the salary ranges from $129,300 to $177,800 annually, complemented by a bonus incentive plan. #J-18808-Ljbffr

Part‑Time Staff Pharmacist - CO/NV The Part‑Time Staff Pharmacist, based in a Cigna office in Denver, CO or Las Vegas, NV, provides telepharmacy services to multiple hospital clients across various states. This role enhances clinical team performance, supports quality patient care, and ensures safe and compliant medication practices. This part‑time position includes evening, overnight, and/or weekend shifts. Shifts available: Saturday and/or Sunday: 6:00 AM - 6:00 PM PST Possible other shifts available: Monday-Friday: 12:30 PM - 8:30 PM PST Monday-Friday: 2:00 PM - 9:00 PM PST Monday-Friday: 7:30 PM - 6:00 AM PST Responsibilities: Telepharmacy Perform remote order entry, order verification, drug verification, and patient/staff counseling. Support multiple clients and operate within various pharmacy information systems (PIS). Clinical Excellence Provide proactive clinical pharmacy services and adhere to all client‑specific and Cigna policies. Deliver drug information and therapeutic recommendations, including dosing adjustments, interactions, compatibilities, and infusion guidance. Maintain working knowledge of IV fluids, TPN, narcotic/cardiac drips, IV antibiotics, chemotherapy, and more. Understand considerations for special populations (pediatric, geriatric, pregnant/nursing, renal/hepatic impairment, HIV). Counsel patients, nurses, and medical staff on safe medication use. Investigate and resolve medication variances within 48 hours. Operational Excellence Learn and work in multiple hospital pharmacy systems. Obtain and maintain multiple state pharmacist licenses. Document orders, interventions, and recommendations in PLRX by end of shift. Ensure compliance with all applicable pharmacy laws, regulations, and internal policies. Technical Excellence Perform basic troubleshooting during system or connectivity issues. Work effectively with VPNs, PIS platforms, automation systems, and common software (Microsoft Office, Snagit, etc.). Training & Development Participate in ongoing training, including clinical updates, PIS enhancements, and policy changes. Maintain all required access credentials, licenses, and reciprocity. Productivity Achieve and maintain company productivity metrics. Qualifications: B.S. in Pharmacy required, PharmD preferred. Active and in good standing Colorado or Nevada pharmacist license. Additional state licenses preferred (AL, LA, MS, MI, SC, NY). 2+ years of inpatient hospital experience preferred. Strong written and verbal communication skills. Demonstrated customer service skills. Knowledge of formulary management and P&T procedures. Familiarity with client/server applications. Proficiency in MS Office, Google Drive, internet, and email. 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.For this position, we anticipate offering an hourly rate of 54 - 91 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. 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: ...@cigna.com for support. Do not email ...@cigna.com 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.

A leading healthcare company is looking for a Director of Authorizations & Eligibility in Washington, D.C. This senior role involves strategic oversight of authorization processes and managing both onshore and offshore teams to ensure compliance with various payer requirements. Candidates should have significant experience in revenue cycle management, especially in complex, multi-site healthcare environments. This position offers a salary range of $115,200 - $158,400 annually and comes with a comprehensive benefits package. #J-18808-Ljbffr

Become a part of our caring community and help us put health first The Principal Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. The Principal Solutions Architect provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. Discover how your passion can make a difference at Humana. Apply today and embark on your career journey with a company recognized as one of the Best Places to Work and named among Forbes America's Best Employers for Tech Workers. Role Overview We are seeking a Principal Solutions Architect to serve as the chief architect for our enterprise Next Best Action (NBA) platform. This position is responsible for defining and/or overseeing the end-to-end architecture, from domain modeling and data ingestion to decisioning, orchestration, and omnichannel activation. The role provides technical leadership across multiple engineering teams, ensuring the NBA platform remains scalable, secure, explainable, and compliant, while supporting highly personalized, real-time engagement across both digital and assisted channels. The Principal Solutions Architect will be accountable for the NBA reference architecture, technical standards, and key design decisions throughout the platform. This individual will collaborate closely with product, engineering, data, machine learning, security, and compliance stakeholders to deliver a unified and future-ready ecosystem. Key Responsibilities Architecture & Technical Leadership Define and maintain the end-to-end NBA platform architecture, encompassing data ingestion, state management, decisioning, business rules, machine learning, and channel activation. Serve as the technical authority across NBA domains, including State Machine, Action Library, Decision Engine, Data and ML Platforms, and Channel & Integration Services. Establish and uphold architectural standards for API-first, event-driven, cloud-native solutions, ensuring consistency across teams and external partners. Review and approve solution designs, major technical decisions, and non-functional requirements related to scalability, resiliency, performance, and security. Decisioning, Rules, and AI/ML Architect decision frameworks that combine business rules, eligibility logic, and machine learning-driven insights. Ensure explainability, auditability, and governance are embedded in decisioning workflows, with a focus on regulated use cases. Partner with data science and ML teams to incorporate feature stores, model serving, and MLOps into low-latency decision services. Data & Event Architecture Define best practices for batch and real-time data ingestion, including event streaming, state transitions, and lifecycle analytics. Drive strong data governance, quality, lineage, and observability across the NBA platform. Align data models and contracts across domains to facilitate reliable orchestration and activation. Activation & Integration Oversee integration approaches for activating NBA decisions across all digital and assisted channels (web, mobile, email, SMS, push, call center, and third-party platforms). Define reusable integration patterns, APIs, and event contracts for consistent and scalable activation. Governance & Compliance Ensure the NBA architecture adheres to security, privacy, and regulatory standards, including robust audit and access controls. Work with security and compliance teams to embed necessary controls into the platform design. Collaboration & Enablement Collaborate with engineering leads, product managers, and vendors to translate business objectives into effective technical solutions. Mentor senior engineers and architects to advance the organization's architectural maturity. Support strategic planning, platform evolution, and build-versus-buy assessments. Use your skills to make an impact Required Qualifications 12+ years of experience in software and platform architecture, including as a principal or lead architect. Demonstrated expertise designing large-scale, cloud-native, distributed systems. Strong hands-on experience with Node.js and/or Python, API design (REST/GraphQL), and event-driven architectures (Kafka or similar). In-depth knowledge of decisioning platforms, rules engines, and ML integration patterns. Experience in regulated enterprise settings (such as healthcare, financial services, or insurance). Excellent communication skills with the ability to influence technical and non-technical stakeholders. Preferred Qualifications Experience building or scaling Next Best Action, personalization, or real-time decisioning platforms. Familiarity with modern data platforms (e.g., Spark/Databricks, Delta Lake, feature stores). Knowledge of MLOps practices and model governance. Experience leading architectural efforts across multi-vendor and distributed teams. Success Criteria A well-defined and widely adopted NBA reference architecture consistently used across teams. Scalable, explainable, and reliable decisioning and activation systems in production. Strong alignment across domain teams with minimal architectural drift. Accelerated delivery of new actions, rules, and models with reduced operational risk. Additional Information Location/Work Style: Remote US Why Humana? At Humana, we know your well-being is important to you, and it's important to us too. That's why we're committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few: Work-Life Balance Generous PTO package Health benefits effective day 1 Annual Incentive Plan 401K - Excellent company match Well-being program Paid Volunteer Time Off If you share our passion for helping people, we likely have the right place for you at Humana. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates 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 SSN Alert Statement Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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. $172,200 - $236,900 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. Application Deadline: 01-23-2026 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our *************************************************************************** #J-18808-Ljbffr

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. This is a remote position, but applicants must be located in the state of Florida. Position Purpose: Oversee a full range of waste, abuse and fraud investigations, audits and medical code editing scenarios. Ensure all audits adhere to federal and state Medicaid fraud, waste and abuse guidelines. Oversee the activities of the SIU for accurate and timely operational reviews and final reviews Interpret audit results and assist health plan executives in the development of appropriate action plans to address identified risks Develop and implement continuous auditing processes from analytic design to final report stage Identify and direct the implementation of new technologies Ensure compliance with all state and federal regulations for fraud and abuse Respond to all legal inquiries including subpoenas and court appearances Attend federal CMS and state fraud meetings with other managed care organizations, and state and federal employees Education/Experience: Bachelor's degree in Accounting, Criminal Justice, Finance, Medical Professional, Economics, Operations Management or related field or equivalent 7+ years of related compliance and/or special investigation experience in managed care or CMS Pay Range: $116,100.00 - $214,700.00 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

As a Pharmacy Technician, you'll help our 95+ million members make the most of our benefit offerings. In this role, you'll set our customers at ease by helping answer their questions and providing solutions to their problems. Above all, you'll make a real impact on the lives of others, day in and day out. Location: 4600 North Hanley, St. Louis, MO 63134 - Onsite position Work Schedules available: PM shift - Mon-Thurs - 3:30PM-2:00AM ( This shift may be eligible for shift differential) AM shift - Sunday -Wednesday - 5:00AM-3:30PM What you will do: Select and retrieve appropriate quantities of medication and prepare the labels that correspond. Works as part of a team in resolving requests in Pull Department, Pull Rx, Letter processing, and Controls exception across ESI as needed. Pull Department responsibilities require walking, standing, and repetitive up and down lifting of boxes weighing 35lb and repetitive pulling of prescriptions 95% of the work time. Pull Rx responsibilities will include pull, copy, fax, and processing. Letter processing will need to provide data entry, type customer service notes, and own total member correspondence. Controls exception will include data verification, QA, and exception processing. Adhere to strict HIPAA regulation especially when communicating to others outside of Express Scripts. All team members will be expected to work as per Policies and Procedures (P &P) and Work Instructions with onsite or offsite departments, internal or external to the company as directed. The weights listed in Essential Functions will vary as size and needs of the department change. All team members are expected to work with Supervisors and Management to cross-train and develop proficiency across all functional areas of the job. Process letter requests by manual or automated databases, typing customer service notes in system, pulling Rx, and processing member correspondence. Pull requests, rescan, and work with RPh to obtain appropriate documentation to resolve request. Controls work includes data input / validation, Quality Assurance (QA), Prescriber and Patient outreach, and working with RPh and Pharmacy per work instructions, P&P, management direction, or any national or state regulations. Participate in Lean and Continuous Improvement efforts internal and external to the department. Perform all QA tasks as identified. Complete and process data for reporting needs. Prepare and organize work for storage both on and offsite. What you will need: HS Diploma or GED required. Valid MO Pharmacy technician license registration required. Minimum of 1 year of relevant experience as a Pharmacy Technician. Certified Pharmacy Technician or NHA preferred. Strong computer skills Word and Excel. Self-motivator with strong organizational skills, attention to detail, and exceptional time management skills. Effective written and oral communication skills. What we Offer: Health coverage effective day 1 (including medical, dental, vision). 401(k) plan with company match. Holiday Pay and Paid Time Off. Education/Certification Program (Grow to Thrive). Career Growth and Advancement opportunities. Physical Requirements: Stand for lengthy periods Lift up to 50 lbs. occasionally and 20 lbs. frequently Perform repetitive motion with fingers, hands, and arms Work may be in confined areas close to machinery Work may be performed in an environment with varying levels of noise 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: ...@cigna.com for support. Do not email ...@cigna.com 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 REQUIRES 50% TRAVEL TO PROVIDERS OFFICES******CANDIDATE MUST RESIDE IN STATE OF INDIANA*** Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Supports the development and implementation of quality improvement interventions and audits in relation to plan providers. Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements. Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure. Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Identifies specific practice needs where Centene can provide support. Develops, enhances and maintains provider clinical relationship across product lines. Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. Ability to travel up to 50% of time to provider offices. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree or equivalent required. 3+ years in HEDIS record collection and risk adjustment (coding) required Licenses/Certifications: One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS For Managed Health Services - IN - No license/certification is 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, 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. Position Purpose: Supports the design of internal communications and promotional products, as well as digital and print field marketing prospect-facing creative projects, Business Development projects, and others as appropriate. Also supports all creative projects involving multiple members of the Medicare Sales Operations department while partnering with Centene Corporate Marketing to ensure all brand standards are followed and implemented. ***PLEASE INCLUDE PORTFOLIO AND/OR LINK*** Supports all aspects of executive and internal communications, as well as external field marketing digital and print design projects. Follows vision, creative solutions, and delivers high quality designs for all assigned tasks. Follows production-based design, receiving and editing design files from various partners and vendors, as well as creation of new materials following the established brand guidelines. Supports the Medicare division and Sales Operations with creative project coordination and production, while ensuring projects are delivered on schedule. Complies with all company policies and brand standards. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's degree in Graphic Design, Marketing, Communications or related field. 1-2 years of related experience in graphic design, branding and identity design work.Pay Range: $27.02 - $48.55 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. ***NOTE: For this role we are seeking candidates who live in Honolulu, Hawaii*** Position Purpose: Manage the daily operations of all provider data management functions. Direct provider data management related activities based on plan and contract specifications and standard business rules - includes data analysis and entry, review of data via internet sites and other systems, usage of multiple systems and applications to validate data is complete and accurate, and investigation and resolution of data issues. Manage the end-to-end provider data entry and maintenance to ensure accurate and timely setup for claims payment, member assignment and directory display Investigate and resolve complex provider data management issues Identify trends and recommend improvements to mitigate potential issues Lead task assignment for team's workflow and distribution Monitor team performance to ensure established and provider data quality benchmarks are met Facilitate meetings with Health Plan representatives Train and mentor Provider Data Management Analyst I, II, and Team Leads Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in related field or equivalent experience. 3+ years of combined management and provider data management, data analysis, and customer service experience preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience in a managed care, insurance, or medical office environment. Experience performing and leading teams.Pay Range: $56,200.00 - $101,000.00 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, 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

A leading healthcare company is seeking an experienced Infrastructure Operations leader to drive innovation in AI and cloud technologies. The ideal candidate will have over 10 years in infrastructure, with a strong background in AI/ML, leading cloud operations for Azure and AWS. Key responsibilities include overseeing cloud strategy and governance, enhancing operational performance, and fostering partnerships across teams. This role offers a competitive salary and benefits focused on well-being. #J-18808-Ljbffr

Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

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 IS REMOTE BUT IDEAL CANDIDATE WILL RESIDE IN MISSOURI, IOWA OR ILLINOIS AND HAVE MANAGED CARE PROCESS IMPROVEMENT EXPERIENCE*** Position Purpose: Support the data management and quality improvement initiatives for assigned functional areas Assist with the development and coordination of all core health services data reports Support the development of quality improvement performance audit function processes and tools Assist in designing, running, managing, and data review process for assuring accuracy and integrity of health services data reports to meet regulatory and operational requirements Report outcomes and quality monitoring results to management Assist with managing databases, policies and procedures related to assigned areas Assist with related activities for various committees and meetings for assigned areas Education/Experience: Associate's degree in related area or equivalent experience. 2+ years of data management, including reporting, project management or quality improvement experience.Pay Range: $23.23 - $39.61 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. Monday-Friday, 8:00 a.m.-5:00 p.m. (some flexibility) Must live in King County, WA - Central/North (Seattle, Tukwila, SeaTac, Burien, Renton) 50%-75% travel within King County Coordinate care for high-risk members; connect to health plan benefits and community resources Address barriers to care (housing, transportation, food insecurity, etc.) Conduct phone outreach to members Visit members at home and in community settings (hospitals, shelters, provider offices, etc.) Position Purpose: Develops, assesses, 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. Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome Develops or contributes to the development of a personalized care plan/service ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care 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 Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or 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 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 manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits 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 2 - 4 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 Pay Range: $22.50 - $38.02 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. This role supports a 24 hour/365 day crisis call center. Applicants must reside in Louisiana. Position Purpose: Work in collaboration with schools of higher education, county first responders, law enforcement, emergency departments, providers, crisis mobile teams and the Cenpatico Crisis Line provider to support the delivery of coordinated and effective crisis services. Develop relationship with all local schools of higher education and coordinate crisis prevention and disaster recovery efforts Verify crisis provider services are delivered in accordance to contract expectations Facilitate the issuing of Corrective Action letters to providers for non-compliance to contract requirements Verify follow-up occurs after crisis interventions to effectively coordinate care Educate local schools of higher education about how to identify the early warning signs of mental illness and what actions to take to safeguard students, faculty and the community Support the Crisis System Plan and the development of provider crisis programs and services within the Provider Network. Monitor the performance of the Crisis Line provider, Crisis Mobile Teams and other providers of crisis services Support the development of Crisis Response Center processes to verify effective coordination of care with other providers Establish baseline data; collect, analyze and report outcomes and progress in reaching program goals. Support the coordination of crisis system processes among system partners, including schools of higher education, crisis providers, intake agencies, emergency rooms, police and fire Conduct root causes analyses, conduct rapid cycle improvement processes Conduct cross departmental and cross system collaborative meetings to execute initiatives and resolve system issues Receive and respond to external system partner related issues in a timely manner Troubleshoot service delivery and coordination issues on behalf of system partners Educate system partners regarding policies and procedures related to referrals, website education, and problem solving Implement and monitor project plans to meet goals and timelines Request corrective action plans from providers that are non-compliant and/or fail to meet contract requirements Develop training modules and train appropriate users Support the involvement of Peer and Family Support Services, and wrap around and community based services to both stabilize and reduce crisis in the community. Provide on-call telephonic coverage 24 hours a day, in rotation as assigned, to provide consultation Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in Behavioral Health or equivalent experience. 5+ years of related experience. Master's degree in Behavioral Health or Social Science preferred. License/Certificates: Licensed Independent Substance Abuse Counselor (LISAC), Licensed Master Social Worker (LMSW), Licensed Bachelor Social Worker (LBSW), Certified Employee Assistance Professional (CEAP) or Licensed Marriage & Family Therapist (LMFT) preferred. For LA Healthcare Connections plan only: One of the following licenses is required: Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), or Licensed Addiction Counselor (LAC) 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, 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