Care Coordinator IV

Centene Management Company LLC; North Carolina; Hybrid; USD 60,000 - 85,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work schedules (remote/Hybrid

Job summary

Centene Management Company LLC is seeking a Care Manager to provide pediatric care coordination for members from birth through age five in North Carolina. The role supports the Pediatric Care Management team with assessments, care plans, and resource connections, operating on a standard schedule with possible flexible arrangements after training.

Candidates must reside in North Carolina and will liaise with care managers, providers, and caregivers to ensure continuity of care and timely service

Qualifications

• Requires High School Diploma or GED.
• Requires 4+ years of related experience.

Responsibilities

• Lead care coordination activities to support prescribed care plans.
• Interact with members via phone, home visits, and in-person outreach to discuss care plans and resources.
• Coordinate care activities with providers, community partners, and caregivers.
• Document and review member records per state and regulatory requirements.
• Triaging and escalating highly complex requests to management as needed.
• Provide education on benefits and resources available and assist with training needs.

Skills

Care coordination

Outreach

Interpersonal communication

Team leadership

Education

High School Diploma or GED

Tools

Documentation systems (EHR)

Job description

The Care Manager will provide care management and coordination for pediatric members from birth through age five. Responsibilities include conducting assessments and screenings, developing care plans, and connecting members and their families with appropriate resources. This position supports the Pediatric Care Management team. 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: Leads the care coordination team to support care management activities to assigned members to ensure appropriate services are delivered by providers and ensure continuity of care across services. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for the member and interacts with members by performing member outreach telephonically or through home-visits. Leads and oversees outreach to members via phone or home visits to engage member and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for both the member and provider 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. Provides continuous support and insight and serves as support on various highly complex member and/or provider inquiries, requests, or concerns related to care plans/service plans. Develops advanced 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. May oversee service assessments/screenings for members with complex needs and documents the member’s care needs. Documents, maintains, and reviews member records in accordance with state and regulatory requirements and provide to providers as needed. Works with care management team with triaging, adjusting, and escalating highly 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 based 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.

Position Purpose

• Leads the care coordination team to support care management activities to assigned members to ensure appropriate services are delivered by providers and ensure continuity of care across services.
• Serves as a liaison alongside care managers and providers to ensure proper coordination of care for the member and interacts with members by performing member outreach telephonically or through home-visits.
• Leads and oversees outreach to members via phone or home visits to engage member and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for both the member and provider 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.
• Provides continuous support and insight and serves as support on various highly complex member and/or provider inquiries, requests, or concerns related to care plans/service plans.
• Develops advanced 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.
• May oversee service assessments/screenings for members with complex needs and documents the member’s care needs.
• Documents, maintains, and reviews member records in accordance with state and regulatory requirements and provide to providers as needed.
• Works with care management team with triaging, adjusting, and escalating highly 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 based 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 4+ years of related experience.

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.

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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.