LTSS Service Care Coordinator

Centene Corporation

2d•$23 - $39

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) AND occasional Mandatory After hours shifts and Saturday shifts, once a month 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 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

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.
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.
For Superior Health Plan Only: Direct experience working with individuals who have disabilities and/or with vulnerable populations who have chronic or complex conditions, including children and young adults within three of the last five years.
Other state specific requirements may apply.
Applicants must physically reside in Texas and be near a Superior Health Plan/Centene office for in-person meetings or training when needed.

Nice To Haves

4+ years of direct healthcare or managed care experience in a 100% INBOUND CALL CENTER environment as this role functions in a clinical phone queue
Direct experience coordinating care and LTSS services for members who are blind, disabled, and over the age of 21
Direct experience engaging and partnering with health care providers and clinical staff via phone and email

Responsibilities

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
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