Senior Health Equity Specialist

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.
 

Candidates must reside in California.

Position Purpose: The Senior Health Equity Specialist is responsible for maintaining compliance with regulations and contractual obligations pertaining to Culturally and Linguistically Appropriate Services (CLAS) and Health Equity within State Health Programs, Commercial and Medicare product lines. The Senior Health Equity Specialist t ensures that culturally and linguistically appropriate services are provided to members, including identifying and implementing health equity initiatives, representing the health plan on national, regional and multi-plan initiatives and assessing operations for gaps. The Senior Health Equity Specialist leverages feedback from providers, members, vendors and community based organizations in the development of strategy and implementation and makes recommendations for CLAS and Health Equity efforts as aligned with contractual, accreditation and quality improvement opportunities to senior management.

• Implements and manages programs in compliance with contracts and regulations and monitors ongoing program performance to maintain compliance.
• Develops strategies and policies to deliver C&L services and maintain compliance with regulatory and contractual obligations.
• Develops, interprets and communicates policies, procedures, regulations and standards.
• Develops California State Health Programs (Medi-Cal) contract content for C&L services, for Medi-Cal, Healthy Families, and Healthy Kids products.
• Prepares P&P’s for committee adoption.
• Implements activities to meet regulatory obligations.
• Monitors compliance with California regulations and State Health Programs contractual obligations.
• Assesses operational gaps compared to new standards and makes recommendations to senior management.
• Represents Health net to Regulators and Accreditation Agencies, demonstrating the provision of culturally & linguistically appropriate health care services.
• Liaisons between community coalitions, California and local regulators, vendors, accrediting bodies and Health Net senior management to increase knowledge of new C&L standards and ensures contract requirements, goals and regulatory are met.
• Monitors/evaluates translation services and interpreter services.
• Evaluates externally translated materials from vendors and provides recommendations to vendor management/contracting.
• Identifies and resolves compliance issues/quality issues related to translating material.
• Identifies and resolves compliance issues/quality issues related to the provision of interpreter services.
• Reviews the translation process and translated materials for improvement opportunities.
• Manages Community Advisory Committees.
• Develops regional goals, outcomes and objectives for Committees.
• Represents and articulates local or regional needs to senior management committees.
• Develops C&L programs to enhance access to care.
• Develops teaching to standard modules for associates for members and providers based on geographic, cultural, and linguistic data.
• Develops teaching to standard modules for providers.
• Reviews member and provider material for cultural and linguistic appropriateness.
• Monitors grievance and appeals processes for C&L issues.
• Proactively identifies areas of improvement for the department and participates in development of improvement plans.

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.  Total compensation may also include additional forms of incentives.

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