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Centene

Runs government-backed health insurance plans

Care Coordinator 2

Medical, Clinical & VeterinaryPosted on Nov 12
Full-timeGeorgia, USANo salary listedRemote

About the Job

Requirements

  • A high school diploma or GED is required.
  • One to two years of related experience is required.
  • Knowledge of medical terminology is required.

Responsibilities

  • Handle inbound and outbound calls to support care management services.
  • Manage call queues, tasks, and referrals in a timely manner.
  • Gather information by phone to determine eligibility for care management enrollment.
  • Route referrals to the appropriate clinical or nursing team.
  • Support care management activities and the teams assigned to members to help ensure services are delivered by healthcare providers and partners and continuity of care and member satisfaction are achieved.
  • Interact with members through telephonic outreach or home visits and document care and service plans.
  • Provide member outreach by phone or home visits to discuss care plans and service plans, including next steps, resources, questions or concerns related to recommended care, and ongoing education as appropriate.
  • Coordinate care activities based on care plans and service plans, working with healthcare and community providers and partners, members, and caregivers to accommodate changes or progress as needed.
  • Support member and provider inquiries, requests, or concerns related to care plans and service plans.
  • Communicate with care managers, practitioners, and others as needed to facilitate member services and ensure continuity of care and service.
  • May support conducting service assessments or screenings for members and documenting member care needs.
  • Document and maintain member records in accordance with state and regulatory requirements and distribute records to providers as needed.
  • Follow standards of practice and policies that comply with contractual requirements and regulatory guidelines and standards.
  • Identify needs and make referrals to Care Managers, community-based organizations, and Disease Managers.
  • Provide education on available benefits and resources.
  • 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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