[Close] 

Supervisor, Medical Management (Clinical)

Position Purpose: Supervise the day-to-day operations of the medical management, utilization and case management functions for the corporate nursing clinical team and centralized transplant unit.
Oversee daily operations of specific areas within the Medical Management department
Assist senior management with input surrounding budgets and forecast for strategic planning and key initiatives. Balance current and future needs effectively.
Ensure compliance with established work processes related to concurrent review, case management, referrals, pre-authorization policies, procedures, and processes
Assure that Medical Management Operational Services functions and responsibilities are coordinated with other operating departments of health plans and Corporate teams
Assist senior management with statistical analysis of utilization data
Education/Experience: Associate's degree in Nursing or equivalent experience for Registered Nurses. Bachelor's degree preferred. Master's degree or equivalent for Licensed Clinical Social Workers and Licensed Physical Therapists.
3 years clinical experience, case/utilization management or quality improvement in a healthcare environment, preferably managed care.
Licenses/Certifications: NYS unrestricted license as Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or Licensed Physical Therapist (PT)
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.

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Medical Management Specialist
Rochester, NY ERIE INSURANCE
RN Manager, Clinical, MLTC
Rego Park, NY Centene Corporation
Manager Network Programs/Clinical Quality - Do...
New York City, NY UnitedHealth Group Inc.
AVP - Managed Care and Clinical
Melville, NY AmTrust Financial Services, Inc.
AVP - Managed Care and Clinical
Latham, NY AmTrust Financial Services, Inc.