Clinical Implementation Specialist

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Facilitate program development and implementation for the Clinical team from requirements gathering to project planning to execution.

• Research and review request for proposal (RFP) and contracts to ensure policies and procedures align with contract requirements for the state and health plan
• Coordinate with various functions on responses for RFP submission, including gathering of success stories and data to support clinical interventions
• Identify NCQA and state requirements and ensure development of compliant program descriptions, policies and materials
• Develop and manage project plan for the implementation and ensure compliance with established timelines
• Serve as the liaison between Cenpatico and new market for the behavioral health product through the implementation phase
• Assist with the development policies and procedures for behavioral health product for new markets
• Assist in the pre-implementation development of the medical necessity criteria, outpatient treatment requests, internal reference documents, and additional internal training documents
• Assist with the development of training materials for providers for new markets., including reference guides and presentation materials, for new markets
• Collaborate with the clinical team and various functions on rational for new clinical programs within the market on return on investment and contract deliverables
• Ability to travel up to 30% of the time
• Performs other duties as assigned
• Complies with all policies and standards

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

Originally posted on Himalayas