Member Certification Manager jobs in Lawton, OK

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: Manage the Member Connections functions, investigate and resolve complex member or provider issues.

• Ensure timely and quality care to members regarding health benefit questions and issues
• Develop, implement and maintain production and quality standards for the Member Connections program
• Identifying high risk members and collaborate with case management to strategize outreach to these high utilizers
• Oversee the processes and auditing of the ConnectionsPlus® program
• Shadow new Member Connection Representatives on home visits and audit results to ensure accuracy and adherence to standards
• Assist in training of Member Connections staff across Centene Health Plans
• Collaborate with Marketing/Communications and Compliance on outreach strategies
• Collaborate with Quality Improvement and Case Management on member initiatives and rounds

Education/Experience: Bachelor’s degree in related field or equivalent experience. Bilingual ability preferred. 4 years of member services, social services, community outreach, or education experience. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

License/Certification: Valid driver's license and automobile insurance.

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 characteristic protected by applicable law.

About the Company:
Oklahoma Complete Health