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Centene Corporation Director, Medical Management Intake in Austin, Texas

Position Purpose:

Oversee all intake core processes across medical management for the plan. Oversee the operations of various functions, including referral management, program coordination, medical management telephonic metrics, connections, authorization requests and case management intake

  • Oversee daily operations and productivity of medical management intake functions, including referrals, program coordination, and connections

  • Develop and implement policies and procedures to ensure compliance with all related laws, regulations and contractual directives

  • Develop, implement, and maintain departmental goals, standards required by the health plan, NCQA, CMS and contractual requirements

  • Ensure accurate, timely, and efficient reporting for intake core processes and connections

  • Establish work directions, resolve problems, and set performance expectations and deadlines to ensure timely completion of all department deliverables

  • Compile and review multiple statistical and financial reports on departmental activities to identify trends and make recommendations for future cost and initiatives

  • Collaborate with various functional areas to development and deployment of programs to support member enrollment and retention, provider satisfaction and increase overall revenue

Education/Experience:

Bachelor’s degree in related field or equivalent experience. 7+ years experience with utilization management and call centers in a managed care or insurance environment, preferably Medicaid and Medicare. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

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.

TITLE: Director, Medical Management Intake

LOCATION: Austin, Texas

REQNUMBER: 1200520

COMPANY: Clinical & Care Management

POSITION TYPE: Both

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