Director - Clinical Program Design

Position Purpose: Direct the implementation and administration of clinical program pilot research and development. Oversee integration of internal operations needed to ensure compliance with developed clinical programs required under state contract, RFP, HEDIS, or other national standards.

Key Details: 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.

• Work with CMO and VP, Clinical Programs on new programs designs.

• Research and facilitate implementation of new clinical programs for all business units to meet State contract, RFP, HEDIS, or other organizational needs.

• Lead cross-functional meetings with various areas to meet overall stakeholder expectations and company’s objectives for clinical programs.

• Oversee creation of policies, procedures, workflow, training materials, and reporting in accordance with corporate, state and federal, HEDIS or other requirements.

• Direct the research and implementation functions for clinical programs to ensure program integrity and compliance.

• Collaborate with the Analytics team to oversee the integrity of clinical programs through robust auditing and outcome reporting

• Coordinate with various departments and business units to develop and execute clinical programs

• Develop clinical program goals and strategy and ensure that new research initiatives, programs or renewal of existing programs represent a meaningful allocation of Centene resources.

• Interact with organizations and State and Specialty Society points of contact as needed.

Education/Experience: Bachelor’s degree in healthcare administration, nursing, public health related field, or equivalent experience. Master’s degree preferred. 7+ years of program development or clinical research experience. Managed care experience preferred.Pay Range: $107,700.00 - $199,300.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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