Community Liaison (State)

Centene Corporation•Woodland Hills, UT

1d•Hybrid

About The Position

Centene is seeking a Community Liaison to maintain collaborative relationships with Health & Family Services, government agencies, community resource and advocacy groups to build additional community support for current and potential enrollees. This role involves working effectively with internal staff, staff at local and state government agencies, and contracted health plans and regulatory/accreditation entities to develop and implement processes to better serve enrollees. The position focuses on establishing and maintaining key community relationships, developing and implementing policy and procedure to facilitate enrollee and provider needs, communicating and resolving care problems, monitoring action plans, facilitating communication between stakeholders, coordinating outreach, and compiling reports for management. For LHCC (LA) only DOJ positions, responsibilities include serving as the LHCC representative, participating in MCO workgroup meetings, serving as the point of contact for the PASRR vendor, contributing to monthly PASRR reporting, performing quality checks on PASRR documentation, ensuring PASRR completion timelines are met, collaborating with LDH/OBH PASRR liaison, and attending state transition coordination meetings.

Requirements

Bachelor’s degree in Social Work, Nursing, or related field.
5+ years of social services or advocacy experience preferably in a Medicaid environment.
Medi-Cal/Medicaid and managed healthcare experience.
Strong relationship builder.
Public speaking and presenting in a public setting.
Strong communication skills.

Nice To Haves

LCSW or RN license preferred.

Responsibilities

Maintain collaborative relationships with Health & Family Services, government agencies, community resource and advocacy groups.
Build additional community support for current and potential enrollees.
Work effectively with internal staff, staff at local and state government agencies, and with contracted health plans and regulatory/accreditation entities to develop and implement processes to better serve enrollees.
Establish and maintain key community relationships throughout State.
Develop and implement appropriate policy and procedure to ensure health plan staff are able to facilitate enrollee and provider needs through entire case management cycle.
Communicate, identify, resolve, and prevent care problems, with other systems of care, as well as government and community agencies.
Monitor and report on achievement of committed action plans.
Facilitate on-going communication between the health plan, provider community, and Health & Family Services.
Coordinate outreach activities to identify enrollees needing care within the urban and rural populations.
Compile and review reports on work function activities for statistical, financial and process improvement tracking purposes.
Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives.
Ensure compliance with State law and regulations.
Serve as the LHCC representative for this program with the state (LHCC (LA) only for DOJ positions).
Participate in MCO workgroup meetings to review and make appropriate changes to the LDH-approved guidance documents for this program (LHCC (LA) only for DOJ positions).
Serve as the point of contact for our delegated PASRR vendor (LHCC (LA) only for DOJ positions).
Contribute to monthly reporting for PASRR submitted to LDH (LHCC (LA) only for DOJ positions).
Perform quality checks on PASRR documentation submitted by vendor before sending to LDH (LHCC (LA) only for DOJ positions).
Ensure timelines for PASRR completion are adhered to (LHCC (LA) only for DOJ positions).
Collaborate w/ LDH/OBH PASRR liaison (LHCC (LA) only for DOJ positions).
Attend state transition coordination meetings as needed (LHCC (LA) only for DOJ positions).
Other duties as assigned.