Fidelis Care Jobs (10)

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Compile and analyze financial information for the Population Health and Clinical Operations team.

• Develop integrated revenue / expense analyses, projections, reports, and presentations
• Budgeting and Forecasting, proforma work ups (cost modeling in excel)
• Create and analyze monthly, quarterly, and annual reports and ensures financial information has been recorded accurately
• Identify trends and developments in competitive environments and presents findings to senior management
• Perform financial forecasting and reconciliation of internal accounts
• Handle complex and high level financial analysis
• Present and discuss analysis with upper management
• Forecast workforce staffing needs

Education / Experience : Bachelor's degree in related field or equivalent experience. 4+ years of financial or data analysis experience.

Advanced skills in Microsoft Excel. Strong Communications and data driven skills.

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.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Responsible for advanced and predictive data analytics from complex and high value projects using big data and data science technology for healthcare innovation and outcomes.

Responsible for conducting complex statistical and algorithmic data analyses and development of technologies to improve the health of members.

Design and develop analysis tools that extract, prepare, and analyze data and store analytical results for downstream analysis and reporting for business needs

Build key data sets to empower operational and exploratory analysis and designing and evaluating experiments monitoring key product metrics, understanding root causes of changes in metrics

Develop tools to convert unstructured data to partially or fully structured representations as well as process large sets of data to derive statistical information.

Apply expertise in quantitative analysis, data mining, and the presentation of data to understand how users interact with business products

Develop of mathematical and statistical models for distinguishing relevant from irrelevant content or events.

Participate in developing presentations and communicate results of research analysis and findings.

Participate in the design of automated, operational analytics processes to achieve scale and durability of analysis processes.

Measure and validate the outcomes of health management programs using SAS, R and other tools, to include provider data, claims data, membership data, etc.

Coordinate analysis and development initiatives and capabilities with health plans.

Manage multiple projects as assigned and assist with training Data Analysts.

Responsible for development efforts with technical team liaisons, including gathering business requirements, documentation, testing, delivery and user adoption, and communicate expectations to the Health Plan.

Education / Experience : Master’s degree in Statistics, Mathematics, Computer Science, Informatics, Econometrics, Engineering, or Experimental Science or related degree and 8+ years of experience;

or Bachelor’s Degree in a quantitative discipline and 10+ years of experience in data science capabilities including data mining, predictive modeling, machine learning, statistical modeling, large scale data acquisition, transformation, and cleaning structured and unstructured data.

Ph.D. degree in a quantitative discipline preferred. Experience working with large databases, data verification and data management.

Experience with database technologies, including Oracle, SAP, DB2, Teradata, MS SQL Server, SAP HANA, MySQL, etc. Data modeling, data architecture, MDM, and data governance experience preferred.

Project experience with Hadoop ecosystem preferred.

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.

Pay Range : $101,500.00 - $187,800.00 per year

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management / Health Services team.

Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Supervisor, Pharmacy Technicians - Clinical Services - Call Center - WFH / Remote

Position Purpose : Supervisor for Pharmacy Technician, Clinical Services (Call Center). Ensure proper workflow and processes to optimize productivity and meet departmental goals.

Monitor daily performance, create reports and audit findings to ensure optimal performance is achieved.

Ensure information is communicated accurately and in a timely manner.

Monitor incoming calls for quality control checks and provide recommendations for improvement.

Communicate with members, providers and pharmacies.

Oversee multiple pharmacy systems.

Develop and deliver training materials for pharmacy technicians and follow policies and procedures.

Work alternative shifts as needed.

Education / Experience : High school diploma or equivalent. Associate's degree preferred. 4+ years of pharmacy technician experience in a mail order prescription facility, hospital pharmacy or retail pharmacy setting.

Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

License / Certification : Current state’s Pharmacy Technician license and National Certification from Pharmacy Technician Certification Board (CPhT) is preferred.

Other Job Specific details :

Supervising 16-18 Pharmacy Technicians (Call Center)

Monitoring daily performance Productivity, Quality & Customer Service.

Coaching

Timecards

Creation / editing of daily plan

Monitoring of workflow and moving of work / techs when needed

Monitoring for compliance issues

Training including listening on calls

Team Meetings

1 : 1 meetings

Interviewing

May have to do the work of the people you manage i.e., jump-in and take calls when needed.

May help the hotline.

Learn other programs and serve as a back-up to other teams.

Additional Supervisor duties as assigned.

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.

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Capture market needs and define requirements, including concept, use cases, feature functions acceptance criteria and growth opportunities

Responsible for strategic and tactical planning activities related to development and deployment of system enhancements

Participate in the design and development of the product strategy, roadmap and priorities

Interface with clients on product design and business requirements

Promote product benefits, capabilities, and value propositions through relationship with key internal and external customers

Gather and analyze feedback from internal and external stakeholders and recommend potential changes

Participate in scrum team meetings as needed to ensure team understands requested functionality and provide backlog prioritization input

Monitor the status of specific development projects supporting new features

Conduct business-level verification and market testing of new features

Education / Experience :

Bachelor’s degree in Computer Science, Nursing, or related field, or equivalent experience. Master’s degree preferred. 7+ years of product management or project management experience in a healthcare enterprise solutions environment.

Experience developing and delivering care management solutions and agile development methodology preferred.

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.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions.

Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.

Interpret and analyze data from multiple sources including healthcare provider, member / patient, and third-party data.

Lead the planning and execution of large-scale projects and new reporting tools, translating business goals into actionable solutions.

Identify and resolve data, process, and technical issues and communicate root-cause with stakeholders as appropriate.

Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners.

Independently engage with business leaders to understand market-specific levers and constraints.

Leverage enterprise reporting tools to rapidly deliver data-driven insights and recommendations.

Research key business problems and proactively identify opportunities for cost and utilization improvements through quantitative analysis.

Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required.

Mentor junior analysts on analytic best practices and business need fulfilment. Delegate tasks to junior analysts, providing guidance and validation where required.

Education / Experience :

Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience.

Master's degree preferred. 5+ years of experience working with large databases, data verification, and data management or 3+ years IT experience.

Healthcare analytics experience preferred.

Experience with table creation and indexing, query optimization, and utilization of stored procedures.

Working knowledge of SQL / querying languages.

Experience with table creation and indexing, query optimization, and utilization of stored procedures.

Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred.

Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI.

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.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Open to candidates living in Eastern Time Zone.

Position Purpose : Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts.

Continuously identify reporting and analytic processes for improvement and automation using Microsoft Power BI, MS SQL, Server Reporting Services (SSRS), SSAS and other analytic / programming tools.

Provide advanced analytical support for business operations in all or some of the following areas : claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.

Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.

Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.

Develop reports and deliverables for management.

Model data using MS Excel, Access, SQL, and / or other data ware house analytical tools.

Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.

Assist with training and mentoring other Data Analysts.

Education / Experience : Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Healthcare experience preferred. Advanced knowledge of Enterprise Reporting and Analysis tools, SQL, and Microsoft Office applications, including Excel and Access.

Experience managing projects or heavy involvement in project implementation. Experience in writing SQL code preferred. Healthcare analytics experience preferred.

BUSINESS ANALYTICS : :

Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or 2+ years of related IT experience, including data warehouse, coding or ETL experience.

Healthcare experience preferred. Advanced knowledge of Enterprise Reporting and Analysis tools, SQL, and Microsoft Office applications, including Excel and Access.

Experience managing projects or heavy involvement in project implementation. Encounters experience preferred.

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.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Open to candidates living in Eastern Time Zone.

Position Purpose : Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts.

Continuously identify reporting and analytic processes for improvement and automation using Microsoft Power BI, MS SQL, Server Reporting Services (SSRS), SSAS and other analytic / programming tools.

Provide advanced analytical support for business operations in all or some of the following areas : claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.

Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources.

Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management.

Develop reports and deliverables for management.

Model data using MS Excel, Access, SQL, and / or other data ware house analytical tools.

Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.

Assist with training and mentoring other Data Analysts.

Education / Experience : Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or data analysis experience.

Healthcare experience preferred. Advanced knowledge of Enterprise Reporting and Analysis tools, SQL, and Microsoft Office applications, including Excel and Access.

Experience managing projects or heavy involvement in project implementation. Experience in writing SQL code preferred. Healthcare analytics experience preferred.

BUSINESS ANALYTICS : :

Bachelor’s degree in related field or equivalent experience. 4+ years of statistical analysis or 2+ years of related IT experience, including data warehouse, coding or ETL experience.

Healthcare experience preferred. Advanced knowledge of Enterprise Reporting and Analysis tools, SQL, and Microsoft Office applications, including Excel and Access.

Experience managing projects or heavy involvement in project implementation. Encounters experience preferred.

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.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements.

• Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
• Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes
• Resolve issues and identify opportunities for process redesign and improvement
• Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements
• Evaluate risks and concerns and communicate to management
• Coordinate with various business units and departments in the development and delivery of training programs
• Develop, share, and incorporate organizational best practices into business applications
• Oversee all changes to departmental policies and procedures, including communicating and implementing the changes
• Serve as the subject matter expert on the assigned function product to ensure operational performance
• Ability to travel

Education / Experience :

Bachelor’s degree in related field or equivalent experience. 6+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 5+ years of managed care encounters experience.

Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid.

Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting preferred.

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.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions.

Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.

Interpret and analyze data from multiple sources including healthcare provider, member / patient, and third-party data

Contribute to the planning and execution of large-scale projects with limited direction from leadership

Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation

Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and / or customers

Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines

Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products

Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners

Independently engage with customers and business partners to gather requirements and validate results

Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required

Provide technical guidance to junior analysts

Education / Experience :

Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience.

Master's degree preferred. 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience.

Healthcare analytics experience preferred. Working knowledge of SQL / querying languages. Preferred knowledge of programmatic coding languages such as Python and R.

Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred.

Preferred knowledge of modern business intelligence and visualization tools including Microsoft PowerBI. Experience in communication measurement and campaign performance analysis preferred.

Experience in Healthcare, Retail, Wholesale preferred. Experience working with in a highly regulated industry preferred.

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.

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time.

As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose : Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives.

• Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment, and closure.
• Utilize corporate and industry standard project management tools and techniques to effectively manage projects.
• Assist with establishment and maintenance of corporate project management methodology and other department procedures.
• Maintain detailed project documentation including meeting minutes, action items, issues lists, and risk management plans.
• Effectively communicate project status to all stakeholders.
• Negotiate with project stakeholders to identify resources, resolve issues, and mitigate risks.
• Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and company's objectives.
• Provide functional and technical knowledge across multiple business and technical areas.
• Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation.
• Create and communicate project milestone documents, dashboards, ROI tables, and departmental success metrics.
• Education / Experience : Bachelor's degree in related area or equivalent experience.
• 3+ years of project management experience.
• Experience working with and leading diverse groups and matrix managed environments.
• Proficient with project management tools, MS-Project or other project management software, and MS-Office applications.
• Healthcare experience preferred.
• Technical background with data analytics, Python and SQL preferred
• Agile or SCRUM experience preferred
• License / Certification : PMP or CAPM certification preferred.

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.