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Join a forward-thinking organization where you can make a significant impact on the health of 28 million members. As a clinical professional in a remote role, you will be integral to our quality improvement efforts, ensuring compliance and promoting preventative health strategies. This position offers the flexibility of working from home while engaging with community partners and providers to enhance access to essential health services. With a strong focus on performance improvement, you will develop outreach initiatives and coordinate with various departments to achieve our goals. Embrace the opportunity to contribute to meaningful change in a supportive and diverse workplace.
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
**THIS POSITION IS REMOTE/WORK FROM HOME AND APPLICANTS MUST RESIDE IN THE STATE OF ILLINOIS.**
**THE ROLE IS PART OF OUR QUALITY IMPROVEMENT GROUP, AND THE WORK SCHEDULE IS MONDAY - FRIDAY 8AM - 5PM CENTRAL TIME ZONE.**
**Position Purpose:**
Monitor and facilitate member access and utilization of the Early Preventative Screening Diagnostic Testing (EPSDT) program and services.
+ Plan, organize and coordinate all aspects of the EPSDT program
+ Ensure compliance of EPSDT with all state and federal requirements and NCQA standards
+ Promote preventative health strategies while interfacing with community partners, engage and assist providers in provision of EPSDT services
+ Conduct outreach to encourage enrollees to access preventative care and assist with making appointments/arrangements as necessary
+ Collaborate with and communicate to providers the importance of all aspects of the EPSDT program, including blood testing, immunization schedules, and periodicity schedule compliance
+ Participate in health fairs and community events to improve program performance
+ Develop newsletters, articles, and web postings centered on EPSDT elements directed at members and providers
+ Assist in the development, implementation and coordination of improvement plans to obtain or surpass the performance goals
+ Coordinate with various internal departments to strategize improvement plan interventions and appropriate outreach activities.
+ Facilitate EPSDT related reviews and follow up that are initiated by the state
+ Attend EPSDT related external meetings as appropriate
+ Develop and analyze reports and studies for variance and outliers, report findings and recommend improvements
+ Ensure that all state mandated reports are completed timely and accurately
+ Performs other duties as assigned.
+ Complies with all policies and standards.
**Education/Experience:**
2+ years of clinical nursing experience. Community relations or public health/service experience preferred.
**Licenses/Certifications:** Current state’s RN license or LPN
For IL health plan, must live in IL
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