Care Coordinator IV - Las Vegas
1 day ago
Job description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Leads the care coordination team to support care management activities to assigned members to ensure appropriate services are delivered by providers and ensure continuity of care across services. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for the member and interacts with members by performing member outreach telephonically or through home-visits.
This is a hybrid position with occasional provider visits, however candidate would need to reside in either Tucson or Tempe Arizona or Las Vegas, Nevada.
- Leads and oversees outreach to members via phone or home visits to engage member and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for both the member and provider throughout care/service, as appropriate
- Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
- Provides continuous support and insight and serves as support on various highly complex member and/or provider inquiries, requests, or concerns related to care plans/service plans
- Develops advanced knowledge of care management services including responding to some complex or escalated issues
- Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care
- May oversee service assessments/screenings for members with complex needs and documents the member's care needs
- Documents, maintains, and reviews member records in accordance with state and regulatory requirements and provide to providers as needed
- Works with care management team with triaging, adjusting, and escalating highly complex requests to management
- Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
- Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
- Provide education on benefits and resources available
- May assist with training and development needs
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience: Requires a High School Diploma or GED.
Requires 4+ years of related experience
Prefer intermediate Excel skills
Knowledge of HEDIS measures is a plus
This is a hybrid position with occasional provider visits, however candidate would need to reside in either Tucson or Tempe Arizona or Las Vegas, Nevada
Pay Range: $ $38.79 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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