• Oversee clinical trial management workstreams • Ensure deliverables meet quality and timeline expectations • Collaborate with cross-functional teams to design and implement effective clinical trial enrollment • Develop and implement comprehensive clinical trial protocols • Manage day-to-day operations of clinical trials, ensuring compliance with regulatory standards • Analyze and interpret clinical trial data, identifying trends and providing insights • Proactively address challenges and implement effective solutions • Communicate effectively with internal and external stakeholders

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. RN or LPN/LVN Compact License Required Hours: M - F 10:00 a.m. - 7:00 p.m. CST or 11:00 a.m. - 8:00 p.m. CST Position Purpose: Drafts correspondence letters based on review outcomes in accordance with National Committee for Quality Assurance (NCQA) standards. Works with senior management to identify and implement opportunities for improvement. - Performs clinical review of outcomes including creating and editing denial letters with the correspondence team based on denial determinations in accordance with National Committee for Quality Assurance (NCQA) standards - Contributes to correspondence letter template creation and maintenance with the correspondence team - Investigates denials through comprehensive review of clinical documentation, clinical criteria/guidelines, and policy, including insurance rejections due to coding issues and provides supplemental information to resolve denial claims - Assists with issues and/or questions related to correspondence with the state, local, and federal agencies including third party payer to ensure issues are resolved in a timely manner - Maintains and monitors cases to ensure timely resolution and logs of actions and/or decisions are appropriately documented - Coordinates with interdepartmental teams on training needed within the utilization management team based on trends - Provides feedback to leadership to improve clinical processes and procedures to prevent recurrences based on industry best practices - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: - LPN - Licensed Practical Nurse - State Licensure required and - For Health Net of California: RN license and - For Superior Plan: RN license Pay Range: $27.02 - $48.55 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

Job Description This role is fully remote and must be located within one of the contiguous 50 states A bit about this role: We want to help members navigate the healthcare system in a better and safer way, and we want to empower members to change the trajectory of their chronic diseases for the better. Disease management is critical to achieving this for our members with diabetes, and we think Certified Diabetes Care and Education Specialists (CDCES) are the perfect people to do this work. The CDCES will be responsible for a panel of members, who primarily have out-of-control diabetes. The CDCES will be responsible for guiding members throughout the entirety of their healthcare journey while enrolled in the specialty clinic. The goal is to “graduate” the members once they are clinically stable and become better self managers of their diabetes through education and counseling via virtual communication (phone and video visits). Required skills and experience: - An active unrestricted Compact Registered Nurse license or an unrestricted Registered Dietitian license. You must be able to obtain additional licenses in states where we operate as needed. - An active Certified Diabetes Care and Education Specialist (CDCES) - At least 2 years of experience clinically managing diabetes Desired skills and experience: - Remote experience managing diabetes strongly preferred - Experience working with diabetes technology (CGMs and insulin pumps) Your Responsibilities and Impact will include: - Screen members for Diabetes Clinic eligibility and appropriateness - Complete detailed assessments and continue following up with members in the Diabetes Clinic to complete ongoing education on all pillars of diabetes management (disease process, medications, glucose monitoring, lifestyle counseling, contingency planning) - Schedule follow-up appointments with self and our providers - Connect members and providers with the right resources within Devoted to troubleshoot clinical issues - Work with the members to create and achieve collaborative SMART goals - Utilize motivational interviewing skills with the goal to influence positive sustained behavioral changes - Identify gaps in care and provide resources - Collaborate with other Diabetes Clinic team members (nurse practitioners, social workers, pharmacists) to develop plans of care and optimize medication regimens to help members achieve goals - Maintain documentation related to member and provider interactions - Continue to improve skill set with participation in education series within the Diabetes Clinic and outside providers of continuing education Salary Range: $80,000 - $95,000 / year #LI-REMOTE The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: - Employer sponsored health, dental and vision plan with low or no premium - Generous paid time off - $100 monthly mobile or internet stipend - Stock options for all employees - Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles - Parental leave program - 401K program - And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission! Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

When our values align, there's no limit to what we can achieve. At Parexel, we all share the same goal - to improve the world's health. From clinical trials to regulatory, consulting, and market access, every clinical development solution we provide is underpinned by something special - a deep conviction in what we do. Each of us, no matter what we do at Parexel, contributes to the development of a therapy that ultimately will benefit a patient. We take our work personally, we do it with empathy and we're committed to making a difference. Key Accountabilities: - Manage external vendors and contract research organizations - Prepare study documents such as the Monitoring Manual, Study Operations Manual, Source Data Verification Plan and Laboratory Manual - Coordinate and be responsible for the design of study materials such as CRFs, patient diaries, study participation cards and source documents - Assist with protocol development and study report completion - Manage monitoring activities (may include routine on-site clinical monitoring) at clinical study sites to assure adherence to Good Clinical Practices (GCPs), SOPs and study protocols - Provide guidance, direction, and management to CRAs - Track patient enrollment; qualify, initiate, monitor, perform closeout activities, and review site reports; and assist in coordination of data management activities - Coordinate study supplies - Negotiate contracts with vendors of clinical trial services - Review Informed Consent Forms, CRFs, and study related materials - Plan and participate in investigator meetings - Assist and support data query process - Ensures trial master file is current and maintained - Collaborate in the management of external vendors and contract research organizations to ensure efficient execution of clinical trials. Skills: - Oversee all aspects of clinical trials from initiation to closeout, ensuring timely completion within budget through effective project management. - Identify and resolve issues that arise in a timely manner during trial execution to minimize delays and maintain study integrity, employing strong problem-solving abilities. - Effectively manage multiple tasks, deadlines, and priorities in a complex clinical trial environment - Clearly convey information and expectations to cross-functional teams, investigators, and stakeholders Knowledge and Experience: - Good Clinical Practices (GCPs) and regulatory compliance (FDA and ICH guidelines) - Experience in clinical trial documentation and processes (e.g., protocols, CRFs, monitoring plans) - Experience of data management and query resolution in clinical trials - Overall knowledge of site management and monitoring procedures Education: - Degree in the life sciences field preferred