Senior Care Navigator - Pediatric

RemoteWorker US; Apopka (FL); On-site; Full time

Job summary

A leading healthcare organization is seeking a Senior Care Navigator specializing in Pediatric care. The role involves assessing and coordinating care management activities for members, working closely with families and caregivers. The ideal candidate will have a Bachelor’s degree along with relevant experience in pediatric care and a passion for improving healthcare access. Offering a competitive salary and comprehensive benefits, this position requires a dedication to community health and a collaborative spirit.

Benefits

Comprehensive benefits package

Health insurance

401K plan

Tuition reimbursement

Paid time off and holidays

Flexible work schedules

Qualifications

• Requires a Bachelor’s degree and 4-6 years of related experience.
• Clinical licensure preferred for nursing degrees.
• Experience in pediatric care is necessary.

Responsibilities

• Assesses, plans, implements, and coordinates care management activities.
• Develops personalized care/service plans for members.
• Coordinates timely access to services and monitors care plans.

Skills

Care Coordination

Advocacy

Psychosocial Support

Education

Bachelor’s degree

Graduate from an Accredited School of Nursing

Job description

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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.

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 the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.

Must reside in Orange, Seminole, Osceola or Brevard County for face to face visits with members.

• Develops or contributes to the development of ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care
• Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members in a timely manner
• May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate
• Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans
• Identifies problems/barriers for care coordination and appropriate care management interventions for members with higher level of care needs
• Reviews referrals information and intake assessments to develop or assist in the development of appropriate care plan/service plan for members with higher level of care needs
• Collaborates with healthcare partners as appropriate to facilitate member care to ensure member needs are met and determine if care plan/service plan revision is needed
• Collects, documents, and maintains all 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 collaborate with providers or resources, as appropriate
• May provide education to care managers and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits
• Serves as a Subject Matter Expert (SME) to support the care navigation team and/or serve as a preceptor for newly hired staff
• Other duties or responsibilities as assigned by people leader to meet the member and/or business needs
• Performs other duties as assigned.
• Complies with all policies and standards.
  
  

Education/Experience: Requires a Bachelor’s degree and 4 – 6 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

License/Certification

• Current state’s clinical license preferred
• For CMS Florida licensed practical nurse with a minimum of four years of pediatric experience, or a Master’s degree in social work with a minimum of one year of related professional pediatric care experience. May require up to 80% local travel required
  
  

Must reside in Orange, Seminole, Osceola or Brevard County for face to face visits with members.

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, 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

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other, Information Technology, and Management

• Industries

  Staffing and Recruiting

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