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Centene

Runs government-backed health insurance plans

Care Navigator

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeMississippi, USA$22.94 - $38.79 /hr

About the Job

Requirements

  • A bachelor's degree and 2–4 years of related experience are required, or equivalent experience acquired through applicable knowledge, duties, scope, and skills reflective of the position level.
  • If holding clinical licensure, graduation from an accredited school of nursing is required.
  • For the Mississippi Magnolia Health plan, a bachelor's or master's degree in a healthcare-related field such as social work, sociology, psychology, or public health, and 2–4 years of related experience are required.

Responsibilities

  • Evaluate member needs, barriers to care, and available resources, and recommend and facilitate an appropriate plan for the best outcome.
  • Develop or contribute to personalized care plans or service plans, and identify providers, specialists, and community resources needed for care.
  • Provide psychosocial and resource support to members, 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 assessments and plans.
  • Coordinate between members or their caregivers and care provider teams 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 applicable; collaborate with healthcare providers to revise plans or address 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 applicable state, federal, and third-party payer regulations.
  • Perform on-site visits as appropriate to assess member needs and collaborate with providers or resources.
  • Provide education to care managers, members, and their families or caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits as applicable.
  • Perform other duties as assigned to meet member or business needs, and comply with all policies and standards.

Desired Qualifications

  • LSW or LMSW 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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