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Centene

Runs government-backed health insurance plans

LTSS Service Care Manager

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timePennsylvania, USA$27.02 - $48.55 /hr

About the Job

Requirements

  • A Bachelor's degree is required, along with 2–4 years of related experience; equivalent experience demonstrated through applicable knowledge, duties, scope, and skill reflective of the position's level may be accepted.
  • Must reside in Pennsylvania.
  • Approximately 50% travel to nursing facilities is required.

Responsibilities

  • Evaluate member needs and available resources, and recommend or facilitate plans for the best outcomes.
  • Assist with developing ongoing long-term care plans or service plans and identify providers, specialists, and community resources needed for long-term care.
  • Coordinate between members or their families and caregivers and the care provider team to ensure identified services are accessible.
  • Provide resource support to members and their families or caregivers for needs such as employment, housing, participant direction, independent living, justice, and foster care, based on service assessments and plans.
  • Monitor care plans or service plans, member status, and outcomes as appropriate, and recommend updates based on identified member needs.
  • Interact with long-term care healthcare providers and partners as appropriate to ensure member needs are met.
  • Collect, document, and maintain long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
  • Perform home or other site visits as appropriate to assess member needs and collaborate with healthcare providers and partners.
  • Provide or facilitate education for long-term care members and their families or caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
  • Provide feedback to leadership on opportunities to improve quality of care and service delivery for long-term care members in a cost-effective manner.
  • Comply with all policies and standards.
  • Perform other duties as assigned.

Desired Qualifications

  • Previous assessment experience is strongly preferred.
  • Experience with Community Health Choices (CHC) is strongly 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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