Care Navigator & Provider Liaison

Centene Corporation; Lansing (MI); On-site; USD 37,000 - 67,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work options (remote, hybrid,

field or office)

Job summary

Centene Corporation is seeking a full-time member outreach specialist to close care gaps and coordinate with providers in Michigan. The role involves education on HEDIS measures, scheduling preventive care, and addressing barriers to care in the provider offices.

You will work with providers and members to enhance access to preventive services, coordinate transport, and document all interactions while ensuring confidentiality of PHI.

Qualifications

• Bachelor's degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field.
• Total of 4 years of experience required for the position; 2+ years in direct patient care, social work, quality improvement or health coaching preferred in managed care.

Responsibilities

• Acts as liaison between member/family, physician and facilities/agencies.
• Faces the provider community as the face of Centene with office staff where services are embedded.
• Educates provider practices in HEDIS measures and coding per NCQA requirements.
• Assesses provider performance data to identify improvement opportunities.
• Collaborates with Provider Relations to improve provider performance in Quality, Risk Adjustment, and Operations.
• Schedules appointments for members with care gaps to access preventive care services.
• Conducts in-office and telephonic outreach and health coaching to support quality initiatives.
• Arranges transportation and follow-up appointments as needed.
• Documents all actions taken regarding member contact.

Skills

Member outreach

Provider collaboration

HEDIS knowledge

Education on preventive care

HIPAA/privacy

Education

Bachelor's degree in Healthcare or related field

Tools

EMR systems

NCQA guidelines

Job description

Centene Corporation is seeking a full-time member outreach specialist to close care gaps and coordinate with providers in Michigan. The role involves education on HEDIS measures, scheduling preventive care, and addressing barriers to care in the provider offices.

You will work with providers and members to enhance access to preventive services, coordinate transport, and document all interactions while ensuring confidentiality of PHI.