Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.

Key Details: This role supports Medicaid LTSS members who are age 21 and older. We are looking for candidates with at least 2 years of experience making outbound calls to members or providers in a remote call center environment, along with 2 years of experience processing healthcare or insurance authorizations and coordinating services for members or providers.

Successful candidates are detail-oriented, flexible, quick learners, and comfortable using web-based systems and CMS platforms.

Work Schedule: Monday–Friday, 8:00 AM–5:00 PM or 8:30 AM–5:00 PM (EST).

• Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service

• Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service

• May apply working knowledge of assigned health plan(s) activities and resources

• Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols

• Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship

• Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed

• Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs

• Performs other duties as assigned

• Comply with all policies and standards

Education/Experience: Requires a High School diploma or GED
Requires 1 – 2 years of related experience
 

Preferred Experience:

• 2+ years supporting adults age 21+ receiving Long-Term Services and Supports (LTSS)
• 2+ years of member or provider outreach in a fully outbound call environment
• 2+ years processing healthcare/insurance authorizations and coordinating member or provider services

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act