Care Management Specialist

7 days ago


Tallahassee, United States Centene Corporation Full time
Job Summary

Centene Corporation is seeking a highly skilled Care Management Specialist to join our team. As a Care Management Specialist, you will play a critical role in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.

Key Responsibilities
  • Evaluate the needs of members, resources available, and recommend and/or facilitate plans for the best outcome
  • Assist with developing ongoing long-term care plans and work to identify providers, specialists, and/or community resources needed for long-term care
  • Coordinate between members and/or family/caregivers and the care provider team to ensure identified services are accessible to members
  • Provide resource support to members and their families/caregivers for various needs based on service assessment and plans
  • Monitor care plans, member status, and outcomes, as appropriate, and provide recommendations to care plans based on identified member needs
  • Interact with long-term care healthcare providers and partners as appropriate to ensure member needs are met
  • Collect, document, and maintain long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
  • May perform home and/or other site visits to assess members' needs and collaborate with healthcare providers and partners
  • Provide and/or facilitate education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
  • Provide 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
  • Perform other duties as assigned
Requirements
  • Requires a Bachelor's degree and 2-4 years of related experience
  • Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope, and skill reflective of the level of this position
  • Valid driver's license
  • LPN or RN preferred
What We Offer
  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • A flexible approach to work with remote, hybrid, field, or office work schedules


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