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Centene

Runs government-backed health insurance plans

Care Coordinator 3

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeIllinois, USA$20.39 - $34.71 /hr

About the Job

Requirements

  • Requires a high school diploma or GED.
  • Requires 2–4 years of related experience.
  • For the Illinois YouthCare plan, requires a bachelor's degree in nursing, social sciences, social work, or a related field.
  • For the Illinois YouthCare plan, requires one year of supervised clinical experience in a human-services field.
  • For the Illinois YouthCare plan, applicants must reside in Illinois.

Responsibilities

  • Provide outreach to members by phone or home visits to discuss care plans or service plans, next steps, resources, questions or concerns related to recommended care, and ongoing education as appropriate.
  • Coordinate care activities based on care plans or service plans, working with healthcare and community providers and partners, members, and caregivers to accommodate changes or progress as needed.
  • Support member or provider inquiries, requests, or concerns related to care plans or service plans.
  • Develop in-depth knowledge of care management services and respond to some complex or escalated issues.
  • Communicate with care managers, practitioners, and others to facilitate member services and ensure continuity of care.
  • Perform service assessments or screenings for members with some complex needs and document their care needs.
  • Document and maintain member records in accordance with state and regulatory requirements, and distribute records to providers as needed.
  • Work with the care management team to triage, adjust, and escalate complex requests to management.
  • Follow standards of practice and policies that comply with contractual requirements and regulatory guidelines and standards.
  • Identify needs and make referrals to a Care Manager, community-based organizations, and a Disease Manager.
  • Provide education on available benefits and resources.
  • May assist with training and development needs.
  • Perform other duties as assigned.
  • Comply with all policies and standards.

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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