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Director - Clinical Operations

Role overview

Qualifications

  • Bachelor's degree
  • 7+ years of related experience
  • Prior management experience
  • Equivalent experience in applicable knowledge and skills

Responsibilities

  • Directs process improvements for clinical initiatives and programs
  • Leads the clinical operations team on performance and improvement
  • Oversees development of clinical initiatives and monitors programs
  • Develops long-term clinical operations strategies and influences decisions

Key facts

Hard skills

Other skills

  • Team Leadership
  • Quality Assurance
  • Communication
  • Collaboration
  • Strategic Planning

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Position Purpose: Directs the development and implementation of clinical initiatives and/or programs to improve care coordination, efficiency, and health and quality outcomes. Oversees the clinical operations team and ensures clinical processes are consistent with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements.


Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.


Applicants for this role have the flexibility to work remotely within the continental United States.



  • Directs process improvements for clinical initiatives and/or programs to improve care coordination, efficiency, and health and quality outcomes
  • Leads the clinical operations team on performance, improvement, and career growth considerations
  • Oversees the development of clinical initiatives and monitors programs to ensure appropriate metrics are in place to deliver efficient health and quality outcomes, improve care coordination, and meet requirements of contracts
  • Leads, develops, and ensures clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements
  • Develops long-term clinical operations strategies and influences decisions by providing recommendations that align to organizational objectives
  • Develops the department budget while collaborating inter-departmentally with senior leadership team
  • Develops the overall strategy for onboarding, hiring, and training clinical operations team members to ensure adequate training and high-quality clinical initiatives and/or programs
  • Works cross functionally to drive process improvements to manage costs and support initiatives to improve health and quality outcomes
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience: Requires a Bachelor's degree and 7+ years of related experience, including prior management experience.


Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range: $146,000.00 - $269,600.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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