Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
*** PLEASE NOTE: THIS POSITION IS A HYBRID REMOTE WITH 50% FIELD VISITS. APPLICANTS SHOULD BE LOCATED IN OR VERY CLOSE TO ONE OF THE FOLLOWING ZIP CODES IN THE HEART OF CHICAGO: 60601-60607, 60608, 60610, 60611, 60612, 60613, 60614, 60618, 60622, 60623, 60624, 60641, 60642, 60647, 60657, 60661. THIS POSITION OFFERS CASE MANAGEMENT SERVICES TO ELDERLY AND DISABILITY WAIVERS MEMBERS UNDER ILLINOIS HEALTH PLAN. ***
Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination.
- Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development
- Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact
- Authorize and coordinate referral for services
- Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care
- Assist in coordinating the development of informal or voluntary services to integrate into the member care plan
- Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services
- Assist member with filing and resolving complaints and appeals
Education/Experience: Bachelor’s degree or Registered Nurse License and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or 6+ years of care management experience. Home health, discharge planning, or long term care experience preferred.
Licenses/Certifications: Valid driver's license. LPN or RN preferred.
For Illinois Plan Only: In addition to the requirements above the employee working on
Physically Disabled/Elderly:
Candidate must meet one of the 3 following criteria:
- 1. RN licensed in Illinois.
- 2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
- 3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly
Additional Details:
• Department: LTSS – Long Term Support Services
• Caseload: LTSS waiver members
• Department: Illinois Health Plan / MED-Case Management
• Caseload: Waiver and Disability Waivers members under Illinois Health Plan.
• Territory: Within the following northern/centrally located Chicago, IL zip codes: 60601, 60602, 60603, 60604, 60605, 60606, 60607, 60608, 60610, 60611, 60612, 60613, 60614, 60618, 60622, 60623, 60624, 60641, 60642, 60647, 60657, 60661). Work-from-home case management role with local home visits. Must reside in the above-mentioned area.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
