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Date posted within:
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Senior Actuarial Assistant
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Assist in financial analysis, pricing and risk assessment to estimate outcomes\. + Apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomes + Assist with developing probability tables based...

Date Post 12/09/2017 - Apply Now - Save Job

Compliance Specialist
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Ensure compliance with contractual requirements and federal and state government reporting and regulations\. Maintain government relations for compliance activities\. + Ensure compliance with contract provisions with various agencies and applicable State and...

Date Post 12/07/2017 - Apply Now - Save Job

Program Specialist II (Social Worker) - MLTSS
Centene Corporation - Westmont , IL

**Description:** Position Purpose: + Identify special needs members through the completion of health screens and other resources + Work with community outreach/member advocates to coordinate member care + Educate providers and community resources on program components and available support...

Date Post 12/06/2017 - Apply Now - Save Job

Referral Specialist I
Centene Corporation - Westmont , IL

**Description:** Position Purpose: Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations\. + Initiate authorization requests for outpatient and inpatient services in accordance with the prior...

Date Post 12/06/2017 - Apply Now - Save Job

Behavioral Case Manager - Cook County - Field based (LCPC or LCS
Centene Corporation - Westmont , IL

**Description:** Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and...

Date Post 12/05/2017 - Apply Now - Save Job

Behavioral Case Manager (LCPC or LCSW)
Centene Corporation - Westmont , IL

**Description:** Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and...

Date Post 12/05/2017 - Apply Now - Save Job

Data Analyst II
Centene Corporation - Westmont , IL

**Description:** Position Purpose: + Analyze health management programs including: data collection, validation and outcome measurement\. May include:o Financial, pharmacy, claims, provider, and member datao IRS, CMS, HHSC, HEDIS reportingo Internal data cleansing and data reconciliation...

Date Post 12/01/2017 - Apply Now - Save Job

Medical Director
Centene Corporation - Westmont , IL

**Description:** Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit\. Provides medical leadership of all for utilization management, cost containment, and medical quality...

Date Post 12/01/2017 - Apply Now - Save Job

Clinical Provider Trainer
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Develop and implement trainings to educate network providers and their staff on the company s clinical philosophy and evidence\-based practice methods\. Collaborate with other staff, departments and health plan staff for maintaining and monitoring the delivery...

Date Post 12/01/2017 - Apply Now - Save Job

Contract Implementation Analyst (Chicago)
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Perform day to day duties and testing of contract implementation, including UAT to ensure that systems accurately reflect a contract s negotiated terms\. + Perform audits of provider setup within the provider information system to ensure accurate contract...

Date Post 11/30/2017 - Apply Now - Save Job

Clinical Provider Trainer
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Develop and implement trainings to educate network providers and their staff on the company s clinical philosophy and evidence\-based practice methods\. Collaborate with other staff, departments and health plan staff for maintaining and monitoring the delivery...

Date Post 11/30/2017 - Apply Now - Save Job

Utilization Manager
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions,...

Date Post 11/29/2017 - Apply Now - Save Job

Denial Coordinator
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Generate and process denial letters and Notice of Action \(NOA\) for pre services, leveling of care and denied medical services\. + Maintain the denial and/or appeals logs and assessments in accordance with associated guidelines + Responsible for the Medical...

Date Post 11/29/2017 - Apply Now - Save Job

Behavioral Referral Specialist I
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Receive, review and process Outpatient Treatment Requests \(OTR\) from providers as it relates to eligibility, benefits and authorization of services\. Resolve issues and educate providers on policies and procedures\. + Review OTR for accuracy and...

Date Post 11/28/2017 - Apply Now - Save Job

Medical Review Nurse
Centene Corporation - Westmont , IL

**Description:** Position Purpose: Perform medical review provider claims, authorizations, and medical records to achieve resolution of authorization issues that result in claims denials or pended claims\. Perform retrospective review for medical necessity appeals against medical review...

Date Post 11/22/2017 - Apply Now - Save Job

Actuary
Centene Corporation - Chicago , IL

**Description:** Position Purpose: Conduct analysis, pricing and risk assessment to estimate financial outcomes\. + Apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomes + Develop probability tables based on analysis of...

Date Post 11/22/2017 - Apply Now - Save Job

Customer Service Representative I
Centene Corporation - Naperville , IL

**Description:** Position Purpose: Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner\. + Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference...

Date Post 11/22/2017 - Apply Now - Save Job

Career Fair - 12/6 & 12/7 - Chicago
Centene Corporation - Chicago , IL

**Description:** JOIN US AT OUR **CAREER FAIR** Wednesday, December 6th,8am \- 5pm Thursday, December 7th, 8am \- 5pm Chicago Marriott Downtown Magnificent Mile 540 N Michigan Ave, Chicago, IL 60611 Interview Rooms are located on the 6th floor Illinicare is currently seeking...

Date Post 11/21/2017 - Apply Now - Save Job

Claims Liaison I
Centene Corporation - Chicago , IL

**Description:** Serve as a liaison between the plan, claims, providers and various departments to effectively identify and resolve claims issues\. Audit check run and send claims to the claims department for corrections Identify any system changes and work notify the Plan CIA Manager to...

Date Post 11/21/2017 - Apply Now - Save Job

Senior Customer Service Representative
Centene Corporation - Naperville , IL

**Description:** Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner\. Using current reference materials, answer inquiries from members and/or providers regarding claims, eligibility, covered benefits, authorizations and...

Date Post 11/17/2017 - Apply Now - Save Job

Clinical Pharmacist
Centene Corporation - Westmont , IL

**Description:** Position Purpose: Define and develop standard and custom formularies for assigned plan\. + Develop clinical criteria for review of medications, recommend plan design changes and communicate recommendations to clients + Monitor and review prior authorization requests for...

Date Post 11/15/2017 - Apply Now - Save Job

Manager, Clinical
Centene Corporation - Chicago , IL

**Description:** Manage clinical services including oversight of clinical policies and procedures, day to day clinical services and staff\. Ensure compliance with established initial and concurrent review, case management, referral, pre\-certification and authorization policies, procedures and...

Date Post 11/14/2017 - Apply Now - Save Job

Behavioral Referral Specialist I
Centene Corporation - Chicago , IL

**Description:** Review OTR for accuracy and completeness of data and interact with providers\. Perform research for OTR discrepancies as identified by providers\. Create member authorizations for approved outpatient therapy services\. Verify member eligibility and provider...

Date Post 11/14/2017 - Apply Now - Save Job