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Centene

Runs government-backed health insurance plans

LTSS Service Care Coordinator

Case Management & AdvocacyPosted on Nov 9
Full-time$22.94 - $38.79 /hr

About the Job

Requirements

  • A Bachelor's degree and one year of related experience are required.
  • For the Illinois Plan serving physically disabled or elderly members, the candidate must meet one of these criteria: hold an Illinois RN license; have 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 hold an LPN license and have one year of experience conducting comprehensive assessments and providing formal services for the elderly.

Responsibilities

  • Assist in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.
  • Evaluate member needs and available resources, and recommend or facilitate plans for the best outcomes.
  • Assist in 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 or 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 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.
  • Perform on-site visits to assess member needs and collaborate with providers or resources, as appropriate.
  • 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.
  • Comply with all policies and standards and perform other assigned duties.

Desired Qualifications

  • Preference is given to applicants with past case management, advocacy, or home-visit/community-travel experience.
  • Preference is given to applicants residing within 25 minutes of Lindenhurst, Illinois.

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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