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Verified Pay $21.93 - $37.30 per hour
Hours Full-time, Part-time
Location Apple River, Illinois

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About this job

You could be the one who changes everything for our 28 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.

*** NOTE: This is a hybrid-remote role with 75% local home visits. We are seeking applicants that reside in the following Illinois counties: Shelby, Moultrie, Douglas, Coles, Edgar, Cumberland, Christian, Clark (nearby cities include: Mattoon, Shelbyville, Sullivan, Tuscola, Charleston, Paris, Greenup, Taylorville, Martinsville). ***

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.

• 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

Education/Experience: Bachelor’s degree or Registered Nurse License and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or 6+ 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.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly
Candidate must meet one of the 3 following criteria:
1. RN licensed in Illinois.
2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

Additional Details:
• Department: MMP WAIVER
• Caseload: Aging & Persons with Disabilities
• Territory: the following Illinois counties: Shelby, Moultrie, Douglas, Coles, Edgar, Cumberland, Christian, Clark (nearby cities include: Mattoon, Shelbyville, Sullivan, Tuscola, Charleston, Paris, Greenup, Taylorville, Martinsville). Work-from-home case management role with local in-home visits. Must reside in or be willing to relocate to the above mentioned area.

Pay Range: $21.93 - $37.30 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. 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.