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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-timeChicago, IL, USA

About the Job

Requirements

  • A Bachelor's degree and one year of related experience are required.
  • For the Illinois Physically Disabled/Elderly plan, the candidate must meet one of these alternatives: hold an Illinois RN license; have a bachelor's or master's degree in a human-services-related field (defined to include 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 be an LPN with one year of experience conducting comprehensive assessments and providing formal services for the elderly.

Responsibilities

  • Evaluate member needs and available resources, and recommend or facilitate plans for the best outcomes.
  • Assist in developing ongoing long-term care or service plans and identify providers, specialists, and community resources needed for long-term care.
  • Coordinate among members, families or caregivers, and care-provider teams 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 assessments and plans.
  • Monitor care plans, member status, and outcomes, and recommend plan updates based on identified 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 to assess member needs and collaborate with providers or resources, as appropriate.
  • Provide or facilitate education for members and 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.
  • Perform other assigned duties and comply with applicable 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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