Care Coordinator III
Remote-OR, United States
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.
- 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 plans
- Develops in-depth knowledge of care management services including responding to some complex or escalated issues
- Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care
- Performs service assessments/screening for members with some complex needs and documents the member’s care needs.
- Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed
- Works with care management team with triaging, adjusting, and escalating complex requests to management
- 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 cased organizations, and Disease Manager
- Provide education on benefits and resources available
- May assist with training and development needs
- Performs other duties as assigned
- Complies with all policies and standards
Requires 2 - 4 years of related experience
License/Certification:
- For Illinois Youth Care Contract: Bachelor’s degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field
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
Job Profile
401(k) Competitive benefits Competitive pay Comprehensive benefits Comprehensive benefits package Flexible approach Flexible work schedules Health insurance Holidays Paid Time Off Stock purchase Stock purchase plans Tuition reimbursement Workplace flexibility
Tasks- Assist with training
- Coordinate care activities
- Document member records
- Educate members on benefits
- Facilitate member services
- Perform member outreach
- Provide education
- Support care management
- Support care management activities
Access Care management Clinical Experience Communication Documentation Education Education on Benefits Healthcare Health Insurance Home visits Insurance Management Member Outreach Nursing Outreach Referrals Regulatory Regulatory Compliance Service Assessment Service assessments Service plans Social Work Teams Training Training and Development Triaging
Experience2-4 years
EducationBachelor's degree Bachelor’s Degree in Nursing Degree in nursing Education GED Healthcare High School High school diploma Insurance Nursing Related Field Social Sciences Social Work
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9