You could be the one who changes everything for our 26 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.

• Coordination and care management of members with lower utilization of home community services (i.e. members attending adult day care services or those who are stable on current medication / treatment regimens).
• Manages an active caseload based on state mandated ratios according to residential setting, case intensity and acuity.
• Ensures comprehensive assessments are completed within required time frames and utilizes knowledge and expertise to assess options for care including use of benefits and community resources.
• Partners effectively with the PCP, Specialist, member, member’s family and integrated care teams (ICT) to develop a Person Centered Care Plan.
• In partnership with the member, family, physician(s), ICT and other providers, assesses short and long term member needs, evaluates the need for alternative services and establishes member driven care management objectives.
• Responsible for coordination of service authorizations (i.e. meals, transportation, activities of daily living).
• Educates on and coordinates community resources with emphasis on medical, behavioral and social services. Applies care management standards and maintains HIPAA standards and confidentiality of protected health information.
• Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.
• Assists with implementation of new and expanding healthcare case management initiatives.
• Assists in implementation of market specific strategies that improve on the quality and outcomes of member's care.
• Represents supervisors and management in meetings or on special assignments.
• Helps establish process improvements leading to best practice and assist in implementing change movement.
• Trains, mentors and provides guidance to new and current Field Service Coordinators regarding policy and procedure, systemic tools, workload and care plan development.
• Performs special projects as assigned.Additional Responsibilities:

Education/Experience:

Bachelor’s degree or Registered Nurse and 3+ years of care management experience, Licensed Practical Nurse and 5+ years of care management experience, or 7+ years of care management experience. Home health, discharge planning, or long term care experience preferred.

Licenses/Certifications: Valid driver's license. LPN or RN preferred.

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.