LTSS Service Care Coordinator

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

NOTE: Applicants must physically reside in Texas and be near a Superior Health Plan/Centene office for in-person meetings or training when needed.

Monday - Friday: 8:00 am - 5:00 pm (CST) AND occasional Mandatory After hours shifts and Saturday shifts, once a month

Position Purpose: 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 on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• 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
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
 

Preferred Work Experience:

• 4+ years of direct healthcare or managed care experience in a 100% INBOUND CALL CENTER environment as this role functions in a clinical phone queue

• Direct experience coordinating care and LTSS services for members who are blind, disabled, and over the age of 21

• Direct experience engaging and partnering with health care providers and clinical staff via phone and email

• Role requires flexibility, adaptability to business changes, strong attention to detail, organizational and time management skills

• Proficient computer skills, knowledge, and be able to navigate and research the internet and working in large databases or provider information systems

• Microsoft Office applications (Excel, Outlook, Word) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)

• Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required.

For Superior Health Plan Only: Direct experience working with individuals who have disabilities and/or with vulnerable populations who have chronic or complex conditions, including children and young adults within three of the last five years. Other state specific requirements may apply. required.

Pay Range: $22.94 - $38.79 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