Job Description

We are seeking compassionate and dedicated individuals to join our Medical Management/Health Services team and make a positive impact on the lives of our 28 million members. At Centene, a national organization, we value workplace flexibility and offer competitive benefits.

Oklahoma Complete Health, a Centene company, is dedicated to providing quality healthcare solutions for the people of Oklahoma. We are committed to fostering an inclusive culture that promotes work-life balance, competitive compensation, and continuous career development. Join us and be part of a collaborative network of innovative thinkers making a difference at the local level.

About the Role:

As a clinical professional on our team, you will be involved in various activities related to medical and psychosocial care coordination. Your responsibilities may include:

• Initiating authorization requests for medical services
• Researching and handling claims inquiries
• Assisting members with appointments and obtaining lab results
• Monitoring inpatient census
• Screening for eligibility and benefits
• Referring members to primary care providers
• Assessing and prioritizing members for case management
• Coordinating services with community organizations
• Representing the plan at marketing and outreach meetings
• Producing and distributing program materials
• Entering data into the system

Requirements:

• Reside in the state of Oklahoma
• High school diploma or equivalent
• 2-3 years of experience in a managed care setting or medical office
• Knowledge of customer service, utilization review, and claims processing practices in a managed care environment
• Proficiency in using office equipment and medical terminology
• For Oklahoma Medicaid and Children’s Specialty contract: Bachelor’s Degree in nursing, psychology, social work, or a related field and at least one (1) year of related professional experience in the human services field serving individuals in Medicaid and/or Foster Care

Our Comprehensive Benefits Package:

• Flexible work options, including remote work and hybrid schedules
• Competitive pay
• Paid time off, including holidays
• Health insurance coverage for you and your dependents
• 401(k) and stock purchase plans
• Tuition reimbursement and training and development opportunities

At Centene, we are committed to diversity and equal opportunity employment. We value the uniqueness of every individual. 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 any other characteristic protected by applicable law.