Clinical Care Specialist
6 days ago
Join Centene Corporation, a leading healthcare company, as a Clinical Care Specialist. In this role, you will play a critical part in our Medical Management/Health Services team, working closely with clinical professionals to ensure our members receive the best possible care.
Job Summary:We are seeking a skilled Clinical Care Specialist to join our team. As a Clinical Care Specialist, you will be responsible for coordinating and integrating medical and long-term care services for our members. This includes conducting assessments, developing care plans, and ensuring seamless delivery of services.
Key Responsibilities:- Conduct thorough assessments with members, caregivers, and providers to identify needs and develop effective care plans.
- Monitor the delivery of services and follow up with members, caregivers, and providers to ensure seamless care coordination.
- Authorize and coordinate referrals for services, ensuring timely and effective delivery.
- Collaborate with discharge planners, physicians, and other stakeholders to ensure appropriate discharge plans and care coordination.
- Assist members with filing and resolving complaints and appeals.
- Direct care to participating network providers, ensuring high-quality services.
- 3+ years of care management experience, preferably in home health, discharge planning, or long-term care.
- NYS RN license required.
- Valid driver's license.
Centene Corporation offers a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off, 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. Total compensation may also include additional forms of incentives.
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.
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