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.
**Candidates residing in the state of Arizona preferred**
**Position Purpose:**
Provides support with identifying, overseeing, and managing the coordination of transition of members in the community. Works with leadership to ensure the timely and safe transition of members in the community from various levels of health care services including coordinating care plans with community care coordinators, educating transition enrollees about services, requirements, limitations, and/or exclusions of services as a result of the transition. May perform and/or assist with member assessment/screenings; may develop and/or assist with developing member transition plan or service plan/care plan.
+ Supports care coordination team, providers, and/or other health care team members to develop an effective transition plan for members in the community and/or into adulthood and adult services/providers, as appropriate
+ Assists with the transition for members in the community based on enrollment or transition of care for services identified
+ Works with care coordination and care management team to identify new member enrollees requiring transition services
+ Ensures existing authorizations are honored during the transition process and works with care management team and providers to address any issues
+ Acts as an available resource for members and their families and/or caregivers to educate on services, requirements, limitations, and/or exclusions of services as a result of transition planning
+ May track and maintains transition metrics including new member assessments, volume of members transitioning into or out of care to identify trends and process improvements, and ensures all transition of care information is appropriately documented
+ Supports with efforts to draft education materials and resources for members on requirements, limitations, or exclusions of services for transition of care
+ Assists with developing education and training programs for care coordination staff and providers to improve transition services for members
+ May evaluate the needs of the member, the resources available, and recommends and facilitates the plan for the best outcome
+ May coordinate as appropriate between the member and/or family/caregivers and the care provider team to ensure members are being effectively treated
+ Interacts with healthcare providers as appropriate to facilitate member care coordination needs
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** 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.
Pay Range: $26.50 - $47.59 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. 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
Job Tags
Hourly pay, Holiday work, Remote job, Flexible hours,
Similar Jobs
Advantage Solutions
...to ensure approved criteria and best practices are following and space allocation / shelf placement needs are met Create and... ...Written & Verbal Communication Skills Ability to Visualize & Plan Objectives & Goals Strategically Environmental & Physical...
Red Tail Residential
...Job Summary Red Tail Residential is seeking a dedicated and experienced Regional Property Manager to oversee multiple properties within our Alaskan portfolio. The ideal candidate will possess strong leadership skills and a comprehensive understanding of property management...
BALLARD PEDIATRIC CLINIC, INC., PS
...Ballard Pediatric Clinic has an opening for a Full time or Part Time Registered Nurse. We are a well-established, very busy clinic located in the Crown Hill neighborhood of Ballard in North Seattle. Primary duties will include, but are not limited to the following:...
Baldor Specialty Foods, Inc.
...Box Truck Driver (CDL Not Required) Pay: $20 per hour + weekly performance incentives (averaging $24 per hour) Our drivers provide exceptional customer service 7 days a week. Every day we deliver to all surrounding areas in New York City, Boston, Maine and...
BRIA
...with a focus on work-life balance. Our rehabilitation centers offer a compassionate care environment, empowering you. Registered Nurse (RN) Benefits: ~ PTO package and paid holidays ~ Growth from within ~ Employee rewards program ~ Sign-on bonus*~ Next...