Clinical Implementation Specialist

Posted 2025-10-26
Remote, USA Full Time Immediate Start
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. Position Purpose: Facilitate program development and implementation for the Clinical team from requirements gathering to project planning to execution. Research and review request for proposal (RFP) and contracts to ensure policies and procedures align with contract requirements for the state and health planCoordinate with various functions on responses for RFP submission, including gathering of success stories and data to support clinical interventionsIdentify NCQA and state requirements and ensure development of compliant program descriptions, policies and materialsDevelop and manage project plan for the implementation and ensure compliance with established timelinesServe as the liaison between Cenpatico and new market for the behavioral health product through the implementation phaseAssist with the development policies and procedures for behavioral health product for new marketsAssist in the pre-implementation development of the medical necessity criteria, outpatient treatment requests, internal reference documents, and additional internal training documentsAssist with the development of training materials for providers for new markets., including reference guides and presentation materials, for new marketsCollaborate with the clinical team and various functions on rational for new clinical programs within the market on return on investment and contract deliverablesAbility to travel up to 30% of the timePerforms other duties as assignedComplies with all policies and standardsEducation/Experience: Bachelor’s degree in Psychology, Social Work, related field or equivalent experience. Master’s degree preferred. 3+ years of combined social work or counseling and implementation experience. Experience with developing or piloting new programs. Pay Range: $55,100.00 - $99,000.00 per yearCentene 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 ActOriginally posted on Himalayas Apply To this Job
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