Care Coordinator III

Carolina Complete Health; North Carolina; Hybrid; USD 52,000 - 75,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Flexible work schedule

Job summary

Centene is seeking a Care Manager to coordinate maternity member care by conducting assessments, developing care plans, and connecting members with resources. The role supports the Maternity Care Management team; pediatric experience is preferred.

Candidates must reside in North Carolina. The ideal candidate has care coordination experience in maternity care, strong technical skills, and will engage with members via phone or home visits, coordinating with providers and community partners to

Qualifications

• Requires a High School diploma or GED.
• Requires 2 - 4 years of related experience.
• Background in maternity care, pediatric experience preferred.
• Reside in North Carolina.

Responsibilities

• Outreach to members via phone or home visits to discuss care plan and resources.
• Coordinate care activities with healthcare providers and partners.
• Respond to inquiries about care plans and provide education on benefits and resources.
• Document member records in accordance with regulatory requirements.

Skills

Care coordination

Maternity care experience

Pediatric experience preferred

Education

High School diploma or GED

Job description

The Care Manager will coordinate care for maternity members by conducting assessments and screenings, developing care plans, and connecting members with appropriate resources. The role will also support other Care Managers with questions or concerns related to maternity and pediatric members. The primary focus is maternity care, and pediatric experience is preferred.

This position supports the Maternity Care Management team.

The ideal candidate has previous care coordination experience, a background in maternity care, and strong technical skills. Pediatric experience is preferred.

The role follows a standard schedule. Flexible scheduling may be available after the employee is hired and completes training.

Candidates must reside in North Carolina.

Position Purpose: Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits.

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plans
• Develops in-depth knowledge of care management services including responding to some complex or escalated issues
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care
• Performs service assessments/screening for members with some complex needs and documents the member’s care needs.
• Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed
• Works with care management team with triaging, adjusting, and escalating complex requests to management
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community cased organizations, and Disease Manager
• Provide education on benefits and resources available
• May assist with training and development needs
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Requires a High School diploma or GED.

Requires 2 - 4 years of related experience

License/Certification

• For Illinois Youth Care plan only: Bachelor’s degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field. Must reside in IL
• For Florida-Sunshine Health Plan - All interactions with members are done telephonically.
• For Arkansas Total Care plan - Bachelor's degree in social science/health-related field or a high school diploma with at least one (1) year of experience coordinating care for developmentally or intellectually disabled clients or behavioral health clients. This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

• 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, including full-time or part-time status.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.

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