Remote Member Care Navigator & Coordination

Centene Corporation; Georgia; Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a Care Coordinator II to provide non-clinical administrative support to the care management team. You will handle inbound and outbound calls, manage call queues and referrals, and collect information by phone to determine eligibility for enrollment.

You will coordinate care activities with providers and community partners, document member plans, educate on benefits, and route inquiries to the appropriate care managers.

Qualifications

• Requires a High School diploma or GED.
• Requires 1 – 2 years of related experience.

Responsibilities

• Handles inbound and outbound calls to support care management services.
• Manages call queues, tasks, and referrals in a timely manner.
• Gathers information by phone to determine eligibility for care management enrollment.
• Routes referrals to the appropriate clinical or nursing team.
• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns.
• Coordinates care activities based on the care plan/service plan with providers and partners.
• Serves as support on inquiries related to care plan/service plan.
• Communicates with care managers and practitioners to facilitate member services.
• May support service assessments/screenings and document member needs.
• Maintains member records in accordance with state/regulatory requirements.
• Follows policies compliant with contractual/regulatory guidelines.
• Identify needs and make referrals to Care Manager and community organizations.
• Provide education on benefits and resources available.
• Performs other duties as assigned.
• Complies with all policies and standards.

Job description

Centene Corporation is seeking a Care Coordinator II to provide non-clinical administrative support to the care management team. You will handle inbound and outbound calls, manage call queues and referrals, and collect information by phone to determine eligibility for enrollment.

You will coordinate care activities with providers and community partners, document member plans, educate on benefits, and route inquiries to the appropriate care managers.