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. Hybrid position. Must reside on Oahu. Requires 12 years of administrative or clerical experience. Previous healthcare experience preferred.
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 12 years of related experience.
License/Certification: For Florida-Sunshine Health Plan - All interactions with members are done telephonically. For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30% required Pay Range: $17.50 - $27.50 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.
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