Senior Care Navigator

Centene; Miami (FL); Remote; USD 80,000 - 100,000; Full time

Job summary

Join a forward-thinking organization dedicated to transforming community health. In this remote role, you will leverage your pediatric expertise to assess and coordinate care for members, ensuring they receive the highest quality of healthcare. Your contributions will directly impact the lives of individuals and families, helping them navigate available services and resources. With a focus on personalized care and advocacy, you'll work collaboratively with a dynamic team to enhance healthcare access and outcomes. This position offers a flexible work environment and a comprehensive benefits package, making it an exciting opportunity for passionate healthcare professionals.

Benefits

Health Insurance

401K

Stock Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Arrangements

Qualifications

• 4+ years of pediatric experience required.
• Bachelor’s degree and clinical licensure preferred.

Responsibilities

• Develops care plans and coordinates communication between members and providers.
• Monitors progress towards care goals and collaborates with healthcare partners.
• Provides psychosocial support and education to members and care managers.

Skills

Pediatric Care

Care Coordination

Communication Skills

Patient Advocacy

Education

Bachelor’s Degree

Clinical Licensure

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.

***Remote role. Candidate must reside in Florida, in Miami-Dade or surrounding areas. Must have four or more years of Pediatric experience and LPN licensure.***

Position Purpose:

Assesses, plans, implements, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to personalized care/service plans for members and educates members and their families/caregivers on available services and benefits to improve healthcare access and quality through advocacy and care coordination.

1. Develops or contributes to ongoing care plans and identifies providers, specialists, and community resources needed for care.
2. Coordinates and manages communication between the member, family/caregivers, and care provider team to ensure timely access to services.
3. Monitors progress towards care plan goals, member status, or changes in condition, collaborating with healthcare providers for revisions or further evaluation as needed.
4. Provides psychosocial and resource support to members/caregivers and care managers to access local resources such as employment, housing, food, education, and more.
5. Identifies problems or barriers in care coordination and implements appropriate interventions for members with higher care needs.
6. Reviews referral information and assessments to develop or assist with care plans for members requiring higher levels of care.
7. Collaborates with healthcare partners to facilitate member care and determine if care plan revisions are necessary.
8. Maintains all member information and documentation to ensure compliance with regulations.
9. May perform on-site visits to assess needs and collaborate with providers.
10. Provides education to care managers and members on procedures, care options, and benefits.
11. Serves as a Subject Matter Expert (SME) and may act as a preceptor for new staff.
12. Performs other duties as assigned to meet member and business needs.
13. Ensures compliance with all policies and standards.

Education/Experience:

Bachelor’s degree and 4–6 years of related experience required. Clinical licensure as a graduate from an accredited nursing school preferred. Equivalent experience may be considered.

License/Certification:

• Current state’s clinical license preferred.
• For CMS Florida licensed practical nurses with at least four years of pediatric experience, or a Master’s in social work with one year of pediatric care experience. Up to 80% local travel may be required.

Pay Range: $26.50 - $47.59 per hour

Centene offers comprehensive benefits including competitive pay, health insurance, 401K, stock plans, tuition reimbursement, paid time off, holidays, and flexible work arrangements (remote, hybrid, field, or office).

Centene is an equal opportunity employer committed to diversity. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.