Qureos Mentor

Centene

<div>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&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
Position Purpose: Responsible for developing and conducting a variety of training programs and/or auditing tools for Member and Provider Service roles in Centene&rsquo;s contact centers.
***The Trainer I role is fully remote. Candidates will be considered nationally. ***
Responsibilities:<ul><li>
Conduct training needs analyses to determine specific training needs for call center staff</li><li>
Identify, select, and develop appropriate training programs, including the selection or design of appropriate training aids</li><li>
Evaluate effectiveness of training programs, including cost and benefit analyses</li><li>
Research, analyze and recommend external training programs</li><li>
Maintain records of training activities and employee progress</li><li>
Assist in auditing work performed by staff and present findings and recommendations for areas of improvement to management</li><li>
Assist with revisions to policy and procedures and/or work process development</li><li>
Performs other duties as assigned</li><li>
Complies with all policies and standards</li></ul>
Education/Experience: Bachelor's degree in related field or equivalent experience. 2+ years of training experience, preferably in a managed care or healthcare environment. 
Pay Range: $56,200.00 - $101,000.00 per year
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</div>

Trainer I

<div>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&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
THIS POSITION REQUIRES THE INDIVIDUAL TO RESIDE IN THE STATE OF ILLINOIS.
THE ROLE IS FULL TIME, MONDAY - FRIDAY 8AM - 5PM, AND WILL NEED TO BE FLEXIBLE TO WORK WHATEVER IT TAKES TO MEET THE BUSINESS NEEDS. 10% TRAVEL FOR REQUIRED MEETINGS.
APPLICANTS SHOULD HAVE EITHER A LCSW, LCPC OR RN LICENSURE WITH BEHAVIORAL HEALTH EXPERIENCE FOR THE STATE OF ILLINOIS.
CADC IS HIGHLY PREFERRED TO SUPPORT SUBSTANCE USE AND BEHAVIORAL HEALTH EXPANSION.
THE POSITION IS SALARIED WITH BONUS ELIGIBILITY.
Position Purpose: Supervises the care management team and the care coordination of behavioral health members to promote quality and efficacy of care management delivery related to mental and behavioral health needs. Supervises day-to-day escalations and care management issues related to members or providers.<ul><li>
Monitors and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements</li><li>
Assigns caseloads to care management staff based on state requirements, care management staff experience, and member needs</li><li>
Works with senior management on escalated and complex care cases related to BH and provides guidance to junior team members to address member concerns</li><li>
Educates and provides resources for care management team on key initiatives and member outreach</li><li>
Evaluates care management team performance and provides feedback regarding performance, goals, and career milestones</li><li>
Provides coaching and guidance to care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits</li><li>
Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on a regular basis</li><li>
Assists with onboarding, hiring, and training care management team members</li><li>
Performs other duties as assigned.</li><li>
Complies with all policies and standards.</li></ul>
Education/Experience: Requires a Master's degree or Graduate from an Accredited School of Nursing and 4+ years of related experience. 
 
License/Certification:<ul><li>
Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required.</li></ul>
Pay Range: $87,000.00 - $161,300.00 per year
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</div>

Supervisor, Care Management

<div>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&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
Position Purpose: The Program Manager is responsible for leading large‑scale, cross‑functional initiatives supporting the National and regulatory Gold Carding programs. This role oversees program planning, execution, governance, and operational readiness, ensuring consistent implementation, compliance, visibility, and performance across markets and regulatory environments.
Responsibilities:<ul><li>
Lead large‑scale, cross‑functional projects supporting Gold Card program implementation, ongoing operations, and process improvement, including collaboration with organizational leaders on team restructuring and realignment as needed.</li><li>
Oversee all aspects of program planning and execution, including scope, schedule, budget, dependencies, and resource alignment, ensuring adherence to project management standards.</li><li>
Drive complex initiatives by coordinating and overseeing the work of project managers and business analysts across multiple workstreams (e.g., Operations, Finance, Benefit Operations, Analytics, Configuration, Regulatory).</li><li>
Provide shared operational support for National and regulatory Gold Card programs, coordinating day‑to‑day activities across analytics, configuration, operations, and other supporting teams.</li><li>
Maintain centralized Gold Card program data, monitoring inputs, documentation, and regulatory artifacts, ensuring accuracy, consistency, and readiness for program use, audits, and executive review.</li><li>
Establish and maintain operational processes, templates, and reference materials to ensure standardization and accessibility for all relevant stakeholders.</li><li>
Support annual reassessment cycles and recurring audit activities through timely coordination of data, documentation, and cross‑functional inputs.</li><li>
Create and maintain reliable tracking mechanisms to provide visibility into in‑flight work across Gold Card initiatives.</li><li>
Develop executive‑level dashboards and status reporting that clearly communicate program health, milestones, risks, and outcomes.</li><li>
Partner with analytics teams to develop reports and dashboards to support ongoing monitoring, performance evaluation, and post‑implementation insights.</li><li>
Proactively manage program risks, issues, dependencies, and budget forecasts across Gold Card initiatives.</li><li>
Serve as the first point of escalation for program risks and issues; work directly with project teams to resolve challenges and develop risk mitigation strategies.</li><li>
Prepare and deliver well‑structured materials for Program Steering Committees and executive leadership, including risk assessments, decision points, and progress updates.</li><li>
Effectively communicate business and operational impacts, regulatory considerations, and proposed solutions to senior leaders.</li><li>
Create and deliver best‑practice guidance and program training to indirect reports, peers, and stakeholders, as applicable.</li><li>
Partner with training teams to develop, review, and maintain Gold Card&ndash;specific training materials to support operational readiness and ongoing adoption.</li></ul>
Education/Experience: Bachelor&rsquo;s degree in related field or equivalent experience required. Master&rsquo;s degree preferred. 8+ years of Program or Project Management experience required. Previous experience as a lead in a functional area, managing cross-functional teams on large scale projects or supervisory experience including hiring, training, assigning work, and managing the performance of staff required. Proficiency in MS Office applications and project management tools required. Healthcare experience and/or managed care experience preferred. 
 
License/Certification: Project Management Professional (PMP) or Program Management Professional (PgMP) preferredPay Range: $87,700.00 - $157,800.00 per year
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</div>

Program Manager – Gold Carding Program

<div>Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. 
This is a hybrid position that includes both in-office and remote work. Candidates must live within a reasonable commuting distance of our Burr Ridge, IL office.
Position Purpose: Provide leadership and oversight of all aspects of finance for the health plan.<ul><li>
Oversee all finance related activities for business unit including developing and monitoring progress against Annual Operating Plan.</li><li>
Responsible for financial analysis, identification of month-end financial drivers, and forecasting including headcount planning to ensure compliance with state requirements.</li><li>
Responsible for identifying medical cost trends and leadership of medical cost improvement initiatives.</li><li>
Perform financial impact analysis for new contracts and support negotiations.</li><li>
Review monthly performance and financial results of the business unit and provide recommendations to senior management.</li><li>
Responsible for the business unit&rsquo;s contribution to corporate.</li><li>
Perform duties as Chief liaison between Corporate Finance and the Business Unit.</li><li>
Establish financial strategic vision, objectives, policies and procedures in support of the overall strategic plan.</li><li>
Oversee and validate pricing models and lead initiatives to identify inefficiencies and areas of development and improvement.</li><li>
Direct health plan analytical needs and coordinate reporting strategy.</li><li>
Act as a lead for internal and external audits.</li><li>
Lead rate setting activity and coordinate corporate and state actuaries.</li></ul>
Education/Experience: Bachelor's Degree in Finance, Accounting, Economics, Business Administration preferred. Master's Degree preferred. 
10+ years in a high-level finance role in the healthcare or insurance industry required.
CPA Preferred 
Must reside in Illinois.
Pay Range: $217,600.00 - $411,800.00 per year
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</div>

Plan Chief Financial Officer

<div>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&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
Please note: candidate must reside within state of Kentucky
Position Purpose: Position acts as a subject matter expert in the field of Compliance and/or Special Investigations Unit (SIU) investigations. Provides direction and guidance to staff who investigate and remediate compliance and fraud, waste, and abuse related matters; while maintaining an investigative workload of moderate to high complexity. Assists manager on monitoring team caseload and report on metrics.<ul><li>
Provides guidance to team members who investigate and remediate compliance and fraud, waste, and abuse related matters</li><li>
Assists manager on monitoring team caseload and report on metrics</li><li>
Identifies training needs and develop training aids and step actions</li><li>
Provides training and mentoring to team on casework and other SIU activities</li><li>
Evaluates and assesses allegations to determine those criteria, including federal and state regulations, Centers for Medicare &amp; Medicaid Services (&ldquo;CMS&rdquo;) guidelines, and internal policies, procedures, and standards that are alleged to have been violated</li><li>
Conducts and documents interviews investigatory purposes</li><li>
Reviews investigative interviews prepared by junior investigators</li><li>
Manages caseloads of moderate to high complexity, develops investigative plans for multiple investigations, prioritizing and managing through execution</li><li>
Thoroughly documents actions, organizes, and reviews case files</li><li>
Consults with management, in-house counsel, and/or senior leadership to resolve difficult or complex issues</li><li>
Identifies risks and recommends and communicates remedial actions to mitigate future potential risks</li><li>
Performs follow up to ensure remedial and disciplinary measures are implemented appropriately and timely</li><li>
Prepares clear and concise investigative plans and reports</li><li>
Provides support and guidance to junior investigative staff</li><li>
Identifies trends and aberrant activity to generate proactive leads for investigations and analyzes data to detect potentially fraudulent activity</li><li>
Attends, actively participates in, and/or leads meetings with various business area managers</li><li>
Communicates directly with Federal or State regulators</li><li>
Prepares cases for referral to management, government agencies, and law enforcement</li><li>
Develops and maintains strong working relationships with associates and regulators</li><li>
Testifies in criminal and civil matters</li><li>
Supports the development and maintenance of Corporate Compliance policies and procedures and workflows</li><li>
Participates in and lead special projects as needed</li><li>
Perform other duties as assigned</li><li>
Complies with all policies and standards</li></ul>
Education/Experience:<ul><li>
Bachelor's Degree in related field; or Associate's degree with 6 years related experience; or High School Diploma/GED with 7 years related experience required</li><li>
Master's Degree preferred</li><li>
5+ years Healthcare fraud-related investigations with audit and risk analysis. required</li><li>
1+ years Managed care or working with health insurance company required</li><li>
In-depth knowledge of government programs, the managed care industry, Medicare, Medicate laws and requirements, federal, state, civil and criminal statutes required</li><li>
Reading, analyzing and interpreting State and Federal laws, rules and regulations. Knowledge of community, state and federal laws and resources required</li><li>
Knowledge and understanding of managed care claims processing systems and medical claims coding preferred preferred</li></ul> 
Licenses/Certifications: 
Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Pharmacy Technician, or other industry related certification preferred
Pay Range: $70,100.00 - $126,200.00 per year
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</div>

Lead SIU Investigator

<div>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&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
Centene is hiring an LTSS Service Care Coordinator for our Illinois market, supporting our Medicaid Aging and Physically Disabled population. In this role, you will conduct in-home visits to complete assessments, coordinate care, and assist members with connecting to providers and DME services.
This is a 75% field-based position covering the Hanover Park, IL area. Candidates must reside within 30 minutes of this area.
Schedule: Monday through Friday, 8:00 a.m. &ndash; 4:30 p.m.
Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.<ul><li>
Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome</li><li>
Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care</li><li>
Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members</li><li>
Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans</li><li>
Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs</li><li>
Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met</li><li>
Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators</li><li>
May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate</li><li>
Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits</li><li>
Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner</li><li>
Performs other duties as assigned</li><li>
Complies with all policies and standards</li></ul>
Education/Experience: Requires a Bachelor's degree and 1 year of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. 
 
Physically Disabled/Elderly 
Candidate must meet one of the 3 following criteria: 
1. RN licensed in Illinois. 
2. Bachelor or Master&rsquo;s Degree prepared in human services related field. Bachelor&rsquo;s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology. 
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly 
Pay Range: $22.94 - $38.79 per hour
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</div>

LTSS Service Care Coordinator

<div>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&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
***NOTE: This is a hybrid-remote role with 75% local home visits focusing on Physically Disabled/Elderly waiver services. Preference will be given to applicants with past case management, advocacy or home visits/community travel experience who are located in the following locations: 60641, 60618, 60613, 60657, 60647, 60614, 60622, 60642, 60610, 60624, 60612, 60607, 60623, 60608, 60610, 60611, 60654, 60661, 60606, 60601, 60602, 60603, 60604, 60607, 60605 in central Chicago neighborhoods, including Downtown, the Near North Side (such as Lincoln Park, Lakeview, Old Town, Gold Coast), Northwest and West Side neighborhoods (such as Logan Square, Avondale, West Town, and Humboldt Park), and select Near South Side neighborhoods (such as Pilsen and Little Village).
Additional Details:<ul><li>Department: Long Term Support Services, Case Management</li><li>Caseload: Physical Disability &amp; Aging Waiver Members</li><li>Schedule: Monday-Friday, 8am-4:30pm (half hour lunch)***</li></ul>
Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.<ul><li>
Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome</li><li>
Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care</li><li>
Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members</li><li>
Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans</li><li>
Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs</li><li>
Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met</li><li>
Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators</li><li>
May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate</li><li>
Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits</li><li>
Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner</li><li>
Performs other duties as assigned</li><li>
Complies with all policies and standards</li></ul>
Education/Experience: Requires a Bachelor's degree and 1 year of related experience. 
 
For Illinois Plan Only: In addition to the requirements above the employee working on 
 
Physically Disabled/Elderly 
Candidate must meet one of the 3 following criteria: 
1. RN licensed in Illinois. 
2. Bachelor or Master&rsquo;s Degree prepared in human services related field. Bachelor&rsquo;s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology. 
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly 
Pay Range: $22.94 - $38.79 per hour
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</div>

Join Centene and explore 17   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Centene

About Company

Trainer I

Supervisor, Care Management

Program Manager – Gold Carding Program

Plan Chief Financial Officer

Lead SIU Investigator

LTSS Service Care Coordinator

LTSS Service Care Coordinator