Care Coordinator III

Centene Corporation•Dayton, OH

1d•$20 - $35•Remote

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. This position supports Long Term Care (LTC) Care Coordination through activities such as member outreach and mailings, appointment scheduling and reminders, prescription coordination, and provider follow-up. Preference will be given to applicants with experience in one or more of the following areas: managed care, physician office or health system operations, healthcare administration, and medical terminology. Must reside in Ohio. This role works with the 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.

Requirements

Requires a High School diploma or GED.
Requires 2 - 4 years of related experience
Must reside in Ohio.

Nice To Haves

Experience in one or more of the following areas: managed care, physician office or health system operations, healthcare administration, and medical terminology.

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.