[Hiring] Manager, Specialty Therapy & Rehabilitation Services @Centene Corporation

Role Description

Manage Specialty Therapy and Rehabilitation Services (STRS) clinical services including management and marketing of clinical services.

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
• Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
• Applicants for this role have the flexibility to work remotely within the continental United States.
• Highly preferred: Clinical experience with Durable Medical Equipment (DME).
• Schedule: The work schedule includes holiday coverage.
• Manage clinical services including oversight of clinical policies and procedures and day-to-day operation.
• Oversee the provider outreach and training activities pre and post implementation.
• Ensure compliance with established initial and concurrent review, referral, and authorization policies, procedures and processes.
• Ensure all programs and clinical operations are in full compliance with state and federal regulations, including HIPAA.
• Ensure payer contract clinical deliverables are met.
• Monitor the effectiveness of existing procedures and outreach/intervention efforts and ensure full compliance with physical, occupational, speech, and home health scope of practice state guidelines.
• Analyze data, monitor trends and recommend potential quality improvement opportunities including provider issues, service gaps, member needs.
• Ensure accurate and timely reporting to health plan partners on authorizations, denials, appeals, provider outreach, call center metrics, and utilization trends to include analytics and interventions.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Master’s degree in Speech, Occupational or Physical Therapy or equivalent.
• 5+ years of specialty therapy or rehabilitation services experience.
• Thorough knowledge of a specialized or technical field such as case and/or utilization management, including review procedures and educational services.
• Supervisory experience preferred.

Requirements

• Current certification/licensure in Speech-Language Pathology, Occupational Therapy, or Physical Therapy in state of practice.

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.