LTSS Service Care Coordinator - STAR Plus

Centene; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading organization in healthcare is seeking a Care Manager to assist in developing holistic care management activities for long-term care members. This position involves evaluating needs, coordinating care plans, and ensuring accessible services. Applicants must reside in Texas and should have a Bachelor's degree along with at least one year of healthcare experience.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Qualifications

• Requires a Bachelor's degree and 1 year of related experience or equivalent.
• 4+ years of direct healthcare experience in inbound call center environment preferred.
• Proficient in using Microsoft Office applications like Excel, Outlook, Word.

Responsibilities

• Assists in developing and coordinating holistic care management activities.
• Evaluates member needs and facilitates care plans for best outcomes.
• Monitors member status and outcomes and provides recommendations.

Skills

Attention to detail

Organizational skills

Time management skills

Communication

Flexibility

Education

Bachelor's degree

Tools

Microsoft Office

Video conferencing platforms

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

NOTE: Applicants must physically reside in Texas and be near a Superior Health Plan/Centene office for in-person meetings or training when needed.

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care 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 collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Preferred Work Experience:

· 4+ years of direct healthcare experience in a 100% INBOUND CALL CENTER environment as this role functions in a clinical phone queue to coordinate LTSS services for members

· Direct experience engaging and partnering with health care providers and clinical staff via phone and email

· Role requires flexibility, adaptability to business changes, strong attention to detail, organizational and time management skills

· Proficient computer skills, knowledge, and be able to navigate and research the internet and working in large databases or provider information systems

· Microsoft Office applications (Excel, Outlook, Word) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)

· Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required.

Pay Range: $22.50 - $38.02 per hour

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

NOTE: Applicants must physically reside in Texas and be near a Superior Health Plan/Centene office for in-person meetings or training when needed.

Monday - Friday: 8:0 am - 5:00 pm (CST)

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care 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 collaborates with providers or resources, as appropriate
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 1 year of related experience or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Preferred Work Experience:

· 4+ years of direct healthcare experience in a 100% INBOUND CALL CENTER environment as this role functions in a clinical phone queue to coordinate LTSS services for members

· Direct experience engaging and partnering with health care providers and clinical staff via phone and email

· Role requires flexibility, adaptability to business changes, strong attention to detail, organizational and time management skills

· Proficient computer skills, knowledge, and be able to navigate and research the internet and working in large databases or provider information systems

· Microsoft Office applications (Excel, Outlook, Word) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)

· Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required.

Pay Range: $22.50 - $38.02 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 , 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

About the company

Centene Corporation is a publicly traded managed care company based in St.

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