Care Coordinator III

Centene Management Company • Carbondale, IL

33d • $20 - $34 • Hybrid

About The Position

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. NOTE: This is a hybrid remote role with occasional local travel (up to 10%) for home visits and team meetings. Preference will be given to individuals who (1) reside in the following Illinois Counties: Perry, Jackson, Union, Alexander, Pulaski, Johnson, Williamson, Franklin, Jefferson, Wayne, Hamilton, Saline, Pope, Hardin, Gallatin, White, Edwards, Wabash; (2) have worked in the child welfare or foster care or post adoption family space, (3) who have a combination of experience in service coordination, case management, community advocacy, behavioral health while using varius office software such as outlook, excel, electronic medical record platforms proficiently. Additional Details: Line of Business: Illinois Health Plan Department: MED-Medical Management (Case Management) Caseload: Youth Care/Foster Care (ages 0-21) Schedule: Monday through Friday, 8am-5pm central Position Purpose: 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. 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. Education/Experience: Requires a High School diploma or GED. Requires 2 - 4 years of related experience License/Certification: 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

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

Nice To Haves

• Preference will be given to individuals who (1) reside in the following Illinois Counties: Perry, Jackson, Union, Alexander, Pulaski, Johnson, Williamson, Franklin, Jefferson, Wayne, Hamilton, Saline, Pope, Hardin, Gallatin, White, Edwards, Wabash; (2) have worked in the child welfare or foster care or post adoption family space, (3) who have a combination of experience in service coordination, case management, community advocacy, behavioral health while using varius office software such as outlook, excel, electronic medical record platforms proficiently.

Responsibilities

• 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.
• 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.

Benefits

• Centene 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees