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Centene Corporation Senior Clinical Systems Specialist in Clayton, Missouri

Position Purpose:

Develop, maintain and manage the relationship with Specialty Companies, Health Plans and other Corporate operational departments (customers) related to new and existing business to promote Medical Management (MM) processes and application integration.

  • Integrate nursing knowledge to enhance business optimization and application development.

  • Identify adjustments to the applications to meet business needs and perform revisions.

  • Collaborate with other departments to identify opportunities for process redesign and improvement related to new business, new programs and modifications to existing business and programs.

  • Formulate and manage work plans related system or process initiatives.

  • Direct and/or perform testing related to application upgrades and/or modifications.

  • Maintain all aspects of the application described as clinical content.

  • Monitor, analyze and coordinate resolution of large scale application issues related to the transfer of member and provider, and/or authorization data.

  • Collaborate with other departments related to new or revised application specifications or enhancements.

  • Maintain MM web page for the Clinical System Management Unit.

  • Ability to travel.

Education/Experience:

Bachelor’s degree in Nursing or equivalent medical-related experience. 5+ years of clinical experience. Project management experience in a clinical environment preferred.

License/Certification:

RN license preferred. Valid driver's license and automobile insurance.Experience with LTSS program preferred. 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. TITLE: Senior Clinical Systems Specialist LOCATION: Clayton, Missouri REQNUMBER: 1212590 COMPANY: Clinical & Care Management POSITION TYPE: Both

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