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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-time$22.94 - $38.79 /hr

About the Job

Requirements

  • A bachelor's degree and one year of related experience are required, or equivalent experience acquired through applicable knowledge, duties, scope, and skill reflective of the position level.
  • For Illinois Plan employees working with Physically Disabled/Elderly candidates, one of the following is required: an Illinois RN license; a bachelor's or master's degree in a human-services-related field, including Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics—Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work, or Sociology; or an LPN license and one year of experience conducting comprehensive assessments and providing formal services for the elderly.
  • For Brain Injury/HIV/AIDS candidates, one of the following is required: an Illinois-licensed RN and a bachelor's degree in Nursing, Social Work, Social Sciences, or Counseling, or four years of case management experience; a certified or licensed social worker with a bachelor's degree in Social Work, Social Sciences, or Counseling, or a Master of Social Work; or an unlicensed social worker with at least a bachelor's degree in Social Work, Social Sciences, or Counseling.
  • Candidates must reside within the designated ZIP codes for their assigned service area.

Responsibilities

  • Evaluate member needs and available resources, and recommend or facilitate a plan for the best outcome.
  • Assist in developing ongoing long-term care plans or service plans and identify providers, specialists, and community resources needed for long-term care.
  • Coordinate among members, their families or caregivers, and care provider teams 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, and recommend plan 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 comply with current state, federal, and third-party payer regulations.
  • Conduct on-site visits as needed to assess member needs and collaborate with providers or resources.
  • Provide or facilitate education for members and their families or caregivers about procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
  • Provide leadership with feedback on opportunities to improve the quality and cost-effectiveness of care and service delivery for long-term care members.
  • Perform other duties as assigned.
  • Comply with all policies and standards.
  • Assist in developing, assessing, and coordinating holistic care management activities to support quality, cost-effective healthcare outcomes.
  • Develop or assist with developing personalized service care plans or service plans for long-term care members and educate members and their families or caregivers about available services and benefits.

Desired Qualifications

  • Experience in case management and supporting waiver populations, including coordinating services and resources for members in the community.

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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