EXHIBIT 32.1

                CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350,
                             AS ADOPTED PURSUANT TO
                  SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

     In connection with the annual report on Form 10-K of Centene Corporation
(the "Company") for the period ended December 31, 2003, as filed with the
Securities and Exchange Commission on the date hereof (the "Report"), the
undersigned, Michael F. Neidorff, President and Chief Executive Officer of the
Company, hereby certifies, pursuant to 18 U.S.C. Section 1350, that:

     (1) the Report fully complies with the requirements of Section 13(a) or
         15(d) of the Securities and Exchange Act of 1934; and

     (2) the information contained in the Report fairly presents, in all
         material respects, the financial condition and results of operations of
         the Company.

                                           /s/ Michael F. Neidorff
                                           -------------------------------------
                                           Michael F. Neidorff
                                           President and Chief Executive Officer
                                           (principal executive officer)

Dated: February 25, 2004