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.
THIS POSITION IS REMOTE/WORK FROM HOME WITH 50% TRAVEL TO SUPPORT PARTICIPANTS RESIDING IN NURSING FACILITIES IN THE FOLLOWING COUNTIES:
SCHUYLKILL, BERKS, LEHIGH, CARTON, LUZERNE, COLUMBIA.
TYPICAL TRAVEL IS NO MORE THAN 2 HOURS ONE WAY FROM HOME ZIP CODE WITH MILEAGE REIMBURSED AT THE CURRENT IRS GUIDELINE RATE ROUND TRIP.
Position Purpose: Responsible for assisting participants with gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, person centered care plan development, assessment, and service coordination.
- Complete assessments with participants, caregivers, natural and community supports, or providers to obtain information regarding client status, support system, and need for services for person centered care plan development
- Monitor delivery of services and follow-up with participants, caregivers, or providers 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 participants person centered service/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 participant with filing and resolving complaints and appeals
- 50% Travel in assigned counties
Licenses/Certifications: Valid driver's license.
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.