Care Navigator

Centene Management Company LLC; California (MO); Hybrid; USD 32,000 - 54,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements: remote,hyb

Field or office work options

Job summary

Centene Management Company LLC is seeking a care management professional to develop and coordinate personalized care plans for members, educate families on benefits, and advocate for access to high-quality care.

The role emphasizes assessment of barriers to care, collaboration with providers, and ongoing support to improve health outcomes across the care continuum. Preference for California residents and PST-hour availability are noted.

Qualifications

• Requires a Bachelor’s degree and 2–4 years of related experience.
• Graduate from an Accredited School of Nursing if holding clinical licensure, or equivalent experience.

Responsibilities

• Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome.
• Develops or contributes to the development of personalized care plans/service plans and coordinates with providers or community resources.
• Provides psychosocial and resource support to members, caregivers, and care managers to access local resources or services.
• Coordinates between the member/family/caregivers and the care provider team to ensure access to services in a timely manner.
• Monitors progress toward care plan goals and coordinates revisions with healthcare providers as needed.
• Collects, documents, and maintains all member information to ensure compliance with state, federal, and third-party payer regulations.
• May perform on-site visits to assess needs and provide education on procedures, instructions, referrals, and benefits.
• Performs other duties and complies with policies and standards.

Education

Bachelor's degree

Nursing licensure or equivalent clinical experience

Job description

Position Purpose

Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.

Key Details

Preference will be given to candidates who reside in California. The role requires availability to work Pacific Standard Time (PST) hours.

Responsibilities

Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome Develops or contributes to the development of a personalized care plan/service ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely manner May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate Collects, documents, and maintains all 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 collaborate with providers or resources, as appropriate May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits Other duties or responsibilities as assigned by people leader to meet the member and/or business needs Performs other duties as assigned. Complies with all policies and standards.

Education and Experience

Requires a Bachelor’s degree and 2 – 4 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay and Compensation

Pay Range: $22.94 - $38.79 per hour

About the Employer

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
• 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.

Equal Opportunity and Diversity

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