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
Direct care to participating network providers
Participate in care management committees and work on special projects related to care management as needed
Education/Experience: 3 years of care management experience preferred, Home health, discharge planning, or long term care experience preferred.
Licenses/Certifications: Valid driver's license. NYS RN license required.
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.