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.

Oklahoma Complete Health, a Centene company, is committed to providing quality healthcare solutions to transform the health of Oklahomans.

At Oklahoma Complete Health, we are community advocates and change-makers in search of an inclusive culture grounded by our commitment to work-life balance, competitive compensation, and continuous career development. Join us and be a part of a collaborative, growing network of innovative thinkers delivering solutions at the local level.

Position Purpose: Supervise the daily operations of the utilization management (UM) department

Supervise the daily operations of the UM staff
Ensure appropriate usage of resources in order to facilitate the UM process
Ensure compliance with applicable state program guidelines
Evaluate compliance policies and procedures and analyze/recommend enhancements
Assist with ensuring consistent data collection from UM staff that is used to assist the company in achieving corporate goals, to improve monitoring and reporting in order to meet external requirements
Identify opportunities for process improvements necessary to facilitate department functions
Educate staff as necessary to ensure consistent performance and adhere to standards
Assist UM Manager and Director with coordinating and facilitating system processes with providers, partners, vendors, and subcontractors as necessary
For MCOs, supervise the Transition of Care staff and provide face-to-face contact with inpatient members at assigned hospitals

**Must reside in Oklahoma**

Education/Experience: 3+ years of utilization management/quality improvement experience. Working knowledge and understanding of basic utilization management and quality improvement concepts. Previous experience as a lead in a functional area or managing cross-functional teams on large-scale projects.

Licenses/Certifications: Current state’s unrestricted license as an LCSW, LMFT, LMHC, LPC, PhD, PsyD, or RN.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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 characteristics protected by applicable law.