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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-timeDeKalb, IL, USA$22.94 - $38.79 /hr

About the Job

Requirements

  • Requires a bachelor's degree and one year of related experience, or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope, and skill reflective of the position level.
  • For the Illinois Plan, employees working with physically disabled or elderly candidates must meet one of these criteria: 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 with one year of experience conducting comprehensive assessments and providing formal services for the elderly.
  • The ideal candidate has case management experience working with waiver populations, care coordination experience, and community resource knowledge.
  • Candidates must reside within or near the service area.

Responsibilities

  • Assist in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.
  • Develop or assist with developing personalized service care plans for long-term care members and educate members and their families or caregivers about available services and benefits.
  • Evaluate member needs and available resources, and recommend or facilitate plans for the best outcomes.
  • Assist with developing ongoing long-term care plans and identify providers, specialists, and community resources needed for long-term care.
  • Coordinate between members or their families and caregivers and the care provider team to ensure members can access identified services.
  • Provide members and 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 care plan changes 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 comply with applicable 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 quality of care and service delivery for long-term care members cost-effectively.
  • Comply with all policies and standards.
  • Perform other duties as assigned.

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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