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.
Oklahoma Complete Health, a Centene company, is committed to providing quality healthcare solutions to transform the health of Oklahomans.
At Oklahoma Complete Health, we are community advocates and change-makers in search of an inclusive culture grounded by our commitment to work-life balance, competitive compensation, and continuous career development. Join us and be a part of a collaborative, growing network of innovative thinkers delivering solutions at the local level.
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
- Develop, assess and adjust, as necessary, the care plan and promote desired outcome.
- Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options.
- Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of members.
- Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs.
- Collaborate with providers, when necessary, to ensure members receive services in-line with current care plans.
- Enter and maintain assessments and pertinent clinical information into various medical management systems.
- Facilitate member access to community based services.
- Perform in home visits.
- Ensure contractual compliance is met.
- For Transition of Care Team:
- Reach members who have been admitted to an in-patient facility and capture them while in-patient, engaging member and continuing outreach Post Discharge.
- Provide quality outreach and education and decrease readmissions to these facilities by means of supporting members with resources to meet their needs in the least restrictive environment.
Must reside in the state of Oklahoma
Education/Experience: Bachelor’s degree in social work, psychology, human resources, counseling, nursing, special education or a closely related field or 2+ years of relevant healthcare experience.
License/Certification: Valid driver’s license and automobile insurance.
For Oklahoma Complete Health - Children’s Specialty Program
Preferred Experience: Instate presence with knowledge of the complex care needs of the population served, particularly children adjudicated, deprived and in custody of the state child welfare or juvenile justice system through formal education, personal, or employment experience. Experience also includes assisting with facility transition, adolescent to adulthood transition, provider terminations, and changes in level of care (BH inpatient to residential care/group home LOC).Pay Range: $25.44 - $45.76 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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.