Full-Time

LTSS Service Care Manager

Posted on 1/11/2025

Centene

Centene

10,001+ employees

Provides health insurance and services

Healthcare

Compensation Overview

$25.97 - $46.68Hourly

Mid, Senior

Durham, NC, USA

Remote option available in North Carolina.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • Requires a Bachelor's degree and 2 – 4 years of related experience.
  • For North Carolina Standard Plan: Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services.
  • RN or LCSW required.
Responsibilities
  • Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.
  • May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.
  • Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome.
  • Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care.
  • Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members.
  • Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans.
  • Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs.
  • Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met.
  • Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
  • May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners.
  • Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
  • Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Centene Corporation operates in the healthcare industry, focusing on providing health insurance and services to individuals, particularly those who are underinsured or uninsured. The company offers a variety of health insurance products, including medical, dental, vision, and behavioral health services, as well as pharmacy benefits. Centene's business model emphasizes a localized approach, allowing it to tailor its services to meet the specific needs of different communities across the United States. This strategy sets Centene apart from competitors by ensuring that care is relevant and accessible to its members. The company generates revenue primarily through premiums collected from its 27.5 million members, amounting to $140.1 billion in 2023. Centene's goal is to improve health outcomes while managing costs, and it is committed to corporate sustainability, addressing social barriers to health, and supporting employee well-being through flexible work arrangements.

Company Stage

IPO

Total Funding

N/A

Headquarters

Saint-Louis, Senegal

Founded

1984

Simplify Jobs

Simplify's Take

What believers are saying

  • Expansion of telehealth services enhances access for underserved populations.
  • ICHRA introduction attracts customers seeking personalized, flexible insurance options.
  • Essential Plan expansion highlights growth potential in low-cost insurance markets.

What critics are saying

  • Increased competition in the Health Insurance Marketplace may impact Centene's market share.
  • Potential regulatory changes in Medicaid and Medicare could affect revenue streams.
  • Economic downturns may decrease premium collections, impacting financial performance.

What makes Centene unique

  • Centene's localized approach tailors healthcare services to specific community needs.
  • The company offers a wide range of health insurance products through local brands.
  • Centene focuses on cost-effective, high-quality care for underinsured and uninsured individuals.

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Benefits

Health Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Vacation

Hybrid Work Options

Flexible Work Hours

INACTIVE