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.
- Develops complex discharge plans based on level of care of members needs determined by needs assessment to ensure appropriate level of care
- Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and clinically appropriate transition plan for the member
- Assists with managing member’s discharge plans to ensure a timely and smooth discharge between levels of care and facilities
- Collects, documents, and maintains all discharge plans taken on member medical records in health management systems according to utilization management policies and guidelines
- Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable
- Provides feedback to leadership on opportunities to improve the discharge planning process for members to ensure high-quality transitional care
- Coordinates and assists with completion of prior authorizations as they related to discharge planning, as applicable
- Assists concurrent review team as needed
- Performs other duties as assigned
- Complies with all policies and standards
Clinical knowledge of discharge planning competencies preferred.
Knowledge of Medicare and Medicaid regulations preferred.
Knowledge of utilization management processes preferred.
License/Certification:
- LPN - Licensed Practical Nurse - State Licensure required
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
