Care Coordinator III

Centene Corporation•Remote-IL, IL

54d•$20 - $35•Remote

About The Position

Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits. This role will support our IL Health Plan Medicaid YouthCare program members. This position is fully remote/work from home with 10% travel to local office for quarterly team meetings. Position requires a Bachelor's degree in nursing, social sciences, social work or related human services/social services field. Applicants must reside in one of these southern IL counties: Alexander, Bond, Clay, Clinton, Crawford, Edwards, Effingham, Fayette, Franklin, Gallatin, Hamilton, Hardin, Jackson, Jasper, Jefferson, Johnson, Lawrence, Madison, Marion, Massac, Monroe, Perry, Pope, Pulaski, Randolph, Richland, Saline, St. Clair, Union, Wabash, Washington, Wayne, Wayne City, White, Williamson. The work schedule is Monday - Friday 8am to 5pm central time zone.

Requirements

Requires a High School diploma or GED.
Requires 2 - 4 years of related experience
For Illinois Youth Care plan only: Bachelor’s degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field. Must reside in IL

Responsibilities

Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member 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
Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plans
Develops in-depth 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
Performs service assessments/screening for members with some complex needs and documents the member’s care needs.
Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed
Works with care management team with triaging, adjusting, and escalating 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 cased 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.