Job Description

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’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

APPLICANTS WITH THE PREFERRED EXPERIENCE AND RESIDING IN TEXAS WILL BE CONSIDERED

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a High School diploma or GED
Requires 1 – 2 years of related experience

Preferred Work Experience:

• 2+ years of care coordination, administering intake health assessments, and/or working directly in a physician office and/or community health clinic.
• Working knowledge of medical terminology and must be proficient utilizing Microsoft Applications (Word, Excel, Outlook, MS Teams, etc).
• Work experience utilizing EMR, EHR, or Case Management systems is preferred.

For Superior Health Plan Only : Direct experience working with individuals who have disabilities and/or with vulnerable populations who have chronic or complex conditions, including children and young adults within three of the last five years required. Other state specific requirements may apply.

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

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