You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination.

Candidates living in IL Zipcode 60201, 60202, 60203, 60204, 60645
60626, 60646, 60659, 60660, 60630, 60625, 60640, 60641, 60618, 60613
60657, 60647, 60614, 60622, 60642, 60610, 60624, 60612, 60607, 60623
60608, 60610, 60611, 60654, 60661, 60606, 60601, 60602, 60603, 60604, 60607, 60605 to apply for the job

• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development
• Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact
• Authorize and coordinate referral for services
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care
• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services
• Assist member with filing and resolving complaints and appeals
• Direct care to participating network providers
• Participate in care management committees and work on special projects related to care management as needed

Education/Experience: Bachelor’s degree or Registered Nurse and 3+ years of care management experience, Licensed Practical Nurse and 5+ years of care management experience, or 7+ years of care management experience. Home health, discharge planning, or long term care experience preferred.

Licenses/Certifications: Valid driver's license. LPN or RN preferred.

NOTE: ILLINOIS LICENSURE IS REQUIRED.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Employee stock purchase plan
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Opportunities for advancement
• Paid sick time
• Paid time off
• Paid training
• Parental leave
• Prescription drug insurance
• Professional development assistance
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work setting:

• Hybrid remote
• Long term care

Experience:

• LTSS or HCBS waiver: 1 year (Required)

License/Certification:

• RN or LPN license (Required)
• driver's llicense (Required)

Work Location: In person

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