Director, Clinical Operations Integrated Duals CM

Centene Corporation • Northampton, MA

1d • Remote

About The Position

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 opportunity that will lead a team of clinicians- experience in this area is highly preferred as well as extensive leadership experience. 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. 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

Requirements

• 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.

Responsibilities

• 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
• 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

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees