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.
** Applicants for this hybrid remote position must reside in the Des Moines area. The role requires approximately 75% local travel and applicants are able to work remotely from their home the remaining time**
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 and 2+years of experience in a social service or health care related setting or Registered Nurse License and 2+ years of experience in a social service or health care related setting.
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.