Director, Case Management - Remote

Jobs for Humanity is dedicated to building an inclusive and just employment ecosystem. Therefore, we have dedicated this job posting to individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Sunshine State Health Plan

[Job Ad] Are you someone who wants to make a difference in the lives of 28 million people? Join our Medical Management/Health Services team and be the catalyst for change. Centene is a national organization that values workplace flexibility and offers competitive benefits to its diverse employees. Position Purpose: As a clinical professional, you will play a vital role in developing and leading a comprehensive Case Management Program in line with our organization's goals and objectives. Responsibilities: - Provide strong operational leadership for the case management functions and team - Conduct needs analysis and planning to ensure efficient and effective care - Collaborate with executive leadership to meet annual targets and manage finances - Ensure compliance with Corporate, State, and NCQA standards - Implement policies and procedures to enhance department efficiency Requirements: - Bachelor's degree in Nursing or a related field - Minimum of 5 years of experience in managed care and acute care settings with complex case management - Previous management experience, including hiring, training, and performance management - Active RN license in Florida (For Florida plan only) - For Florida plan only: Must have an RN, LCSW, LCMHC, or other Clinical Mental Health Professional license - Familiarity with Medicaid managed care practices, policies, and programs like CHIP and SCHIP Children's Team: Experience working with children who have chronic or complex conditions is required for this specific team. 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 opportunities At Centene, we are an equal opportunity employer that values diversity and appreciates our differences. We are committed to creating an inclusive environment where all qualified applicants 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. If you're ready to make a positive impact and contribute to improving the lives of millions, apply now! [Response] Dear [Hiring Manager], I am writing to express my interest in the clinical professional position on your Medical Management/Health Services team. I believe I have the skills and experience necessary to make a difference in the lives of your 28 million members. The opportunity to work with Centene, a company that values workplace flexibility and offers competitive benefits, is truly appealing to me. In my previous roles, I have demonstrated a strong ability to develop and lead comprehensive Case Management Programs. I have always worked with the larger organizational goals and objectives in mind, ensuring that the care provided is aligned with them. Collaborating with executive leadership to achieve targets and manage finances has been a key part of my experience. I have also been responsible for implementing policies and procedures to improve efficiency and ensure compliance with industry standards. With a Bachelor's degree in Nursing and over five years of work experience in managed care and acute care settings, I have gained the necessary knowledge and skills to excel in this role. Moreover, my previous management experience, including hiring, training, and performance management, has prepared me to lead a team effectively. I have an active RN license in Florida, making me a suitable fit for the role within the state. I must also highlight my experience working with children who have chronic or complex conditions. This specific expertise allows me to contribute to your Children's Team effectively. What excites me about this opportunity is the chance to contribute to positive change and improve the lives of millions. Your comprehensive benefits package, including flexible work solutions, competitive pay, and professional development opportunities, only adds to my enthusiasm. I appreciate Centene's commitment to diversity and inclusion. As an individual who values equality, I am glad to be part of an organization that recognizes and appreciates the unique qualities we all bring. I am confident that my skills, passion, and dedication align perfectly with Centene's values. Thank you for considering my application. I look forward to discussing how I can make a meaningful impact on your team. Sincerely, [Your Name] ---------- Bullet Points: - Bachelor's degree in Nursing or related field - Over 5 years of experience in managed care and acute care settings with complex case management - Previous management experience, including hiring, training, and performance management - Active RN license in Florida (For Florida plan only) - Experience working with children who have chronic or complex conditions (for Children's Team) - Strong leadership and operational skills - Excellent understanding of Medicaid managed care practices and policies, including CHIP and SCHIP - Familiarity with Corporate, State, and NCQA standards - Ability to develop and implement efficient policies and procedures - Flexible work solutions, including remote options and hybrid work schedules - Competitive pay and comprehensive benefits package - Commitment to diversity and inclusion