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

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.

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

Education/Experience: 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.

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

Pay Range: $87,700.00 - $157,800.00 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