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Centene

Runs government-backed health insurance plans

LTSS Service Care Coordinator

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeOak Lawn, IL, USA

About the Job

Requirements

  • A bachelor's degree and one year of related experience are required, or equivalent experience demonstrated through applicable knowledge, duties, scope, and skills.
  • For the Illinois plan, employees working with Physically Disabled/Elderly candidates must meet one of these criteria: be an Illinois-licensed registered nurse; hold a bachelor's or master's degree in a specified human-services-related field; or be a licensed practical nurse with one year of experience conducting comprehensive assessments and providing formal services for the elderly.
  • Case management experience is preferred, especially with Home and Community-Based Services waiver populations.
  • Experience coordinating care, connecting members to community resources, and supporting complex medical and social needs is highly preferred.

Responsibilities

  • Evaluate member needs and available resources, and recommend or facilitate a plan for the best outcome.
  • 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 members and their families or caregivers with resource support 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, and recommend changes based on identified member needs.
  • Interact with long-term care healthcare providers and partners to ensure member needs are met.
  • Collect, document, and maintain long-term care member information and care management activities to ensure compliance with applicable state, federal, and third-party payer regulations.
  • Conduct on-site visits when needed to assess member needs and collaborate with providers or resources.
  • Provide or facilitate education for members and their families or caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
  • Provide leadership with feedback on opportunities to improve quality of care and service delivery cost-effectively.

Desired Qualifications

  • Experience working with Home and Community-Based Services waiver populations.
  • Experience coordinating care, connecting members to community resources, and supporting complex medical and social needs.

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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