Centene Corporation

Compensation

Full Description

Job Description: • Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. • May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. • Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome. • Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care. • Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members. • Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans. • Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs. • Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met. • Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators. • May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners. • Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits. • Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner. Requirements: • Must Reside in NC • Willing to Travel between Winston-Salem, NC and Gastonia, NC • Field Work Required (75%) • Care Management • Face to Face Assessments • Excellent Customer Service and Communication Skills • Requires a Bachelor's degree and 2 – 4 years of related experience. • Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. • License/Certification: For North Carolina Tailored Plan: Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services. RN or LCSW / LCSW-A preferred Benefits: • competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules