Manager, Medical Management RN - Centene (Austin, TX)

osition Purpose: Responsible for managing a complete program of medical management in accordance with the mission, philosophy, and objectives of plan. The position has oversight for the functions of utilization management and case management. Position Responsibilities: Implement changes to medical service functions and performance in relation to company mission, philosophy objectives and policies, as directed. Manage budgets and forecast for strategic planning and key initiatives. Balance current future needs effectively. Assure that Medical Services functions and responsibilities are coordinated with other operating departments of the Plan and Corporate. Responsible for the statistical analysis of utilization data. Participates in NCQA accreditation of the Plan. Knowledge/Experience: Bachelor's degree in nursing or equivalent experience. 3+ years of nursing experience, including quality improvement experience in a healthcare environment, preferably in managed care. Licenses/Certifications: Current state's registered nurse license. Preferred Experience: Commercial Managed Care experience at least 2 years. Source:

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