4 Centene Corporation jobs in St. Louis
Managed Care Contracting Manager
Posted 13 days ago
Job Viewed
Job Description
As the Managed Care Contracting and Provider Relations Manager, you will be responsible for expanding and optimizing our national payor network strategy. This high-impact leadership role is focused on securing new payor agreements, re-negotiating existing contracts, and fostering strong relationships with managed care organizations to ensure timely patient access to our services. Leveraging your established industry connections and deep knowledge of managed care contracting, you will proactively identify opportunities, overcome network entry barriers, and create value-driven partnerships that highlight the benefits we deliver to payors and their members.
This position is ideal for a strategic, results-driven individual with strong negotiation skills and national experience navigating complex payor landscapes.
Lead all aspects of managed care contract negotiations, including new agreements, amendments, and renewals with commercial, Medicare Advantage, and other managed care payors
- Develop and execute a comprehensive contracting strategy that aligns with organizational growth goals and enhances patient access to in-network services
- Utilize established payor relationships to accelerate network entry opportunities, reducing reliance on standard Letter of Interest (LOI) processes
- Act as the primary liaison with payors, maintaining positive relationships and resolving contract-related issues promptly
- Collaborate with internal stakeholders (Operations, Finance, Revenue Cycle, Legal) to ensure contracts are financially sound, compliant, and operationally feasible
- Monitor market trends, competitive activity, and regulatory changes impacting managed care contracting and reimbursement
- Partner with leadership to identify and pursue new payor partnerships that expand our national footprint
- Track, analyze, and report on contract performance and financial outcomes, identifying opportunities for improvement or renegotiation
- Represent the organization professionally in all interactions with external payor representatives, demonstrating our value proposition and commitment to member outcomes
Skills
Provider Contracting, Managed Care, Network Development, Risk-Based Contracts, Fee-for-Service (FFS), Contract Negotiation, Reimbursement Models, Medicare/Medicaid, Credentialing, ERGS, Per diems, United Health Group, Managed Care contracting, pay methodologies, case rate, time-limited filling, Provider Onboarding, Relationship Building, Physician Engagement
-Minimum of 3 years of managed care contracting experience with proven success negotiating payor agreements. At least 5 years in a healthcare network management, payor relations, or provider contracting role is strongly preferred
- Demonstrated success building relationships and influencing decision-makers within major national payor organizations
- In-depth understanding of managed care principles, reimbursement methodologies, and commercial and Medicare Advantage markets
- Strong negotiation skills with the ability to develop creative contracting solutions and drive favorable outcomes
- Proven ability to manage multiple high-priority projects simultaneously in a fast-paced environment
- Excellent communication, presentation, and interpersonal skills
- Self-motivated, strategic thinker with a solutions-oriented mindset
- Knowledge of revenue cycle processes and the impact of payer contracts on operational and financial outcomes is a plus
- Ability to handle sensitive information with discretion and professionalism
Pay and Benefits
The pay range for this position is $36.00 - $36.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending
Healthcare Services Pharmacist
Posted 2 days ago
Job Viewed
Job Description
**Job Summary:**
Provides clinical services to patients, such as immunizations or MTM interventions, ensuring the compliance with regulatory guidelines, company policies and procedures.
**Job Responsibilities:**
Patient Experience
+ Engages patients by greeting them and offering assistance with products and services. Resolves patient issues in a timely manner and answers questions to ensure a positive patient experience.
+ Models and shares patient service best practices with all team members to deliver a distinctive and joyful experience, including interpersonal habits that show care (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., demonstrating curiosity to identify needs and proactively helping, servicing until satisfied, championing empathy and inclusivity, etc.).
+ Connects with patients by anticipating needs and proactively offering services. Supports efforts on enhancing patient experience by increasing awareness of healthcare services offered through Walgreens (e.g., patient consultation, medication management, drug therapy reviews, and perform clinical, or wellness services such as immunizations, diagnostic testing, and patient outcomes services) thereby promoting the shift of the Walgreens pharmacy role from transactional to interpersonal.
Operations
+ Provides clinical services to patients, such as immunizations or MTM interventions, ensuring compliance with regulatory guidelines, company policies and procedures.
+ Ensures the use of all elements of the Good Faith Dispensing policy in conjunction with state and federal controlled substance laws when filling prescriptions. The Product Review/Retail Fill Process Pharmacist is responsible for ensuring that elements of Good Faith are present.
Training & Personal Development
+ Maintains current knowledge and required licensing/credentialing/certification as established by federal and state regulations to provide such clinical services.
+ Maintains current knowledge and skills related to pharmacy and healthcare by reading pharmacy related journals, company publications, and communications. Maintains awareness of developments in retail and management and pursues best practices that would enhance performance.
+ Obtains necessary certifications, education credits and training, including learning modules, as required by the Company.
**About Walgreens**
Founded in 1901, Walgreens ( ) has a storied heritage of caring for communities for generations, and proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico, and leading omni-channel platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for retail pharmacy and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
**Job ID:** BR
**Title:** Healthcare Services Pharmacist
**Company Indicator:** Walgreens
**Employment Type:** Multi-Location Pharmacist
**Job Function:** Retail
**Full Store Address:** 8571 WATSON RD,WEBSTER GROVES,MO, -S
**Full District Office Address:** 8571 WATSON RD,WEBSTER GROVES,MO, -S
**External Basic Qualifications:**
+ BS in Pharmacy or Pharmacist Degree from an accredited educational institution.
+ Current pharmacist licensure in the states within the district.
+ Certified Immunizer or willing to become an immunizer within 90 days of hire.
**Preferred Qualifications:** The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits ( . If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits
We will consider employment of qualified applicants with arrest and conviction records.
**Shift:**
**Store:** 07680-WEBSTER GROVES MO
Registered Nurse - Open Position - Maxim Healthcare Services
Posted 1 day ago
Job Viewed
Job Description
Maxim Healthcare Services is seeking a Registered Nurse (RN) to assume responsibility and accountability for the application of the nursing process and the delivery of patient care. The Registered Nurse (RN) demonstrates the ability to make clinical judgments in an effective and efficient manner under the direction of the Director of Clinical Services.
Responsibilities
- Utilizes the nursing process to assess, plan, implement and evaluate patient care.
- Assess signs and symptoms indicating physiologic and psychosocial changes in the patient’s condition.
- Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
- Documents the patient’s plan of care using identified nursing diagnoses, expected patient outcomes, and selected nursing interventions.
- Performs interventions according to identified priorities, plan of care, and the hospital policies and patient care outcome standard.
- Revises the plan of care according to evaluation, changes in medical plan of care, and effective/ineffective nursing interventions.
- Uses clinical judgment in evaluation activities to meet patient care needs of an assigned unit/floor including establishing priorities.
- Other Registered Nurse (RN) duties as assigned.
Requirements
- Current Registered Nurse (RN) License for the state in which the nurse practices.
- Current Health Certificate (per facility Registered Nurse (RN) contract or state regulation).
- Current PPD or Chest X-Ray.
- Current BLS card.
- One year prior Registered Nurse (RN) experience preferred.
Benefits
At Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
- Competitive pay & weekly paychecks
- Health, dental, vision, and life insurance
- 401(k) savings plan
- Awards and recognition programs
About Maxim Healthcare Services
Maxim Healthcare Services has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
Registered Nurse - Open Position - Maxim Healthcare Services
Posted 1 day ago
Job Viewed
Job Description
Maxim Healthcare Services is seeking a Registered Nurse (RN) to assume responsibility and accountability for the application of the nursing process and the delivery of patient care. The Registered Nurse (RN) demonstrates the ability to make clinical judgments in an effective and efficient manner under the direction of the Director of Clinical Services.
Responsibilities
- Utilizes the nursing process to assess, plan, implement and evaluate patient care.
- Assess signs and symptoms indicating physiologic and psychosocial changes in the patient’s condition.
- Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
- Documents the patient’s plan of care using identified nursing diagnoses, expected patient outcomes, and selected nursing interventions.
- Performs interventions according to identified priorities, plan of care, and the hospital policies and patient care outcome standard.
- Revises the plan of care according to evaluation, changes in medical plan of care, and effective/ineffective nursing interventions.
- Uses clinical judgment in evaluation activities to meet patient care needs of an assigned unit/floor including establishing priorities.
- Other Registered Nurse (RN) duties as assigned.
Requirements
- Current Registered Nurse (RN) License for the state in which the nurse practices.
- Current Health Certificate (per facility Registered Nurse (RN) contract or state regulation).
- Current PPD or Chest X-Ray.
- Current BLS card.
- One year prior Registered Nurse (RN) experience preferred.
Benefits
At Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
- Competitive pay & weekly paychecks
- Health, dental, vision, and life insurance
- 401(k) savings plan
- Awards and recognition programs
About Maxim Healthcare Services
Maxim Healthcare Services has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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