LTSS Service Care Coordinator - STAR Plus

CenteneArlington, TX
224d$22 - $38

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: Applicants must physically reside in Texas and be near a Superior Health Plan/Centene office for in-person meetings or training when needed. Monday - Friday: 8:00 am - 5:00 pm (CST). Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome.

Requirements

  • Requires a Bachelor's degree and 1 year of related experience or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Nice To Haves

  • 4+ years of direct healthcare experience in a 100% INBOUND CALL CENTER environment as this role functions in a clinical phone queue to coordinate LTSS services for members.
  • Direct experience engaging and partnering with health care providers and clinical staff via phone and email.
  • Role requires flexibility, adaptability to business changes, strong attention to detail, organizational and time management skills.
  • Proficient computer skills, knowledge, and be able to navigate and research the internet and working in large databases or provider information systems.
  • Microsoft Office applications (Excel, Outlook, Word) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing).
  • Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required.

Responsibilities

  • Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care.
  • Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members.
  • Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans.
  • Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs.
  • Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met.
  • Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
  • May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate.
  • Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
  • Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible approach to work with remote, hybrid, field or office work schedules

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Industry

Ambulatory Health Care Services

Education Level

Bachelor's degree

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