Pennsylvania Health & Wellness
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.
THIS POSITION IS REMOTE/WORK FROM HOME WITH 50% TRAVEL IN ADAMS COUNTY, PA. MUST RESIDE IN ADAMS COUNTY PA.
MILEAGE IS REIMBURSED AT THE CURRENT IRS GUIDELINE RATE ROUND TRIP.
Position Purpose: Responsible for assisting participants with gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, person centered care plan development, assessment, and service coordination. Complete assessments with participants, caregivers, natural and community supports, or providers to obtain information regarding client status, support system, and need for services for person centered care plan development
Monitor delivery of services and follow-up with participants, 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 participants person centered service/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 participant with filing and resolving complaints and appeals
Role will travel 50% of the time to visit members transitioning from nursing facilities back into the community with mileage reimbursement round trip at the current IRS guideline rate. Education/Experience:
Registered Nurse (RN) or Bachelor’s Degree in social work, psychology, or related field. 3+ years of experience in a social service or health care related setting or 1 year of experience with LTSS or Managed Care
Licenses/Certifications: Valid driver’s license.
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.