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Centene

Runs government-backed health insurance plans

Care Navigator

Medical, Clinical & VeterinaryPosted on Nov 12
Full-timeMissouri, USA$22.94 - $38.79 /hr

About the Job

Requirements

  • A bachelor's degree and 2–4 years of related experience are required.
  • Candidates holding clinical licensure must have graduated from an accredited school of nursing.
  • Equivalent experience may satisfy the education and experience requirement when acquired through accomplishments demonstrating applicable knowledge, duties, scope, and skills reflective of the position level.
  • A Missouri LPN license is preferred.
  • A current state clinical license is preferred.

Responsibilities

  • Develop, assess, and coordinate care management activities based on member needs to support quality, cost-effective healthcare outcomes.
  • Develop or contribute to personalized care plans or service plans and educate members and their families or caregivers about available services and benefit options to improve healthcare access and receive appropriate, high-quality care through advocacy and care coordination.
  • Evaluate member needs, barriers to care, and available resources; recommend and facilitate a plan for the best outcome.
  • Identify providers, specialists, and community resources needed for ongoing care plans or service plans.
  • Provide psychosocial and resource support to members or caregivers and care managers to access local resources or services, including employment, education, housing, food, participant direction, independent living, justice, and foster care, based on service assessment and plans.
  • Coordinate between members or their families or caregivers and the care provider team to ensure identified care or services are accessible in a timely manner.
  • Monitor progress toward care plan or service plan goals and member status or changes in condition as appropriate; collaborate with healthcare providers to revise plans or address member needs, and refer to care management for further evaluation as appropriate.
  • Collect, document, and maintain member information and care management activities to ensure compliance with current state, federal, and third-party payer regulations.
  • Perform on-site visits as appropriate to assess member needs and collaborate with providers or resources.
  • Educate care managers, members, and their families or caregivers about procedures, healthcare provider instructions, care options, referrals, and healthcare benefits as appropriate.
  • Perform other duties as assigned to meet member or business needs.
  • Comply with all policies and standards.

Desired Qualifications

  • A Missouri LPN license is preferred.
  • A current state clinical license is preferred.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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