Clinical Implementation Specialist

6 days ago

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Centene Corporation

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Contracting • Network Development • Managed Care

10,000+

Description

• Facilitate program development and implementation for the Clinical team from requirements gathering to project planning to execution. • Identify NCQA, PQA 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 a liaison to ensure key information for successful program development and implementation is gathered • Assist with the development policies and procedures for programs which improve gap closure and medication adherence across multiple lines of business • Assist in the pre-implementation development of the program launches including requirement gathering • Collaborate with the clinical team and various functions on rational for new clinical programs within the market on return on investment and contract deliverables • 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

Requirements

• Bachelor’s degree in a related field or equivalent experience • Master’s degree preferred • 3+ years of implementation experience • Experience with developing or piloting new programs • Knowledge of NCQA and PQA is highly preferred

Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules