LTSS Service Care Coordinator (Centene)

Job Description

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: This is a hybrid-remote role with 75% local facility visits. We are seeking applicants that reside in the following Illinois counties: Rock Island but open to considering Mercer (nearby cities include: Rock Island, Moline, East Moline, Silvis). Preference for applicants who (1) reside in Rock Island County, (2) have the human services related bachelor’s degree as well as care management experience with the following populations: elderly, persons with disabilities, persons with developmental disabilities, and (3) have a willingness to travel locally daily for facility visits.***

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.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

***Additional Details:

• Line of Business: Illinois Meridian Health Plan

• Department: MED-Case Management / Long Term Care Coordination / LTSS

• Caseload: Aging and Physical Disability waiver members (ages 18 and up)

• Schedule: Monday through Friday, 8-4:30 PM CT

• Territory: Rock Island (nearby cities include: Rock Island, Moline, East Moline, Silvis). Work-from-home case management role with local facility visits (up to 75% travel). Role may involve traveling to other parts of the region depending on business needs.***

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