Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.

Key Details: Seeking candidates with 3+ years of healthcare administrative support experience in both inbound and outbound call center environments. Ideal candidates will have a proven ability to coordinate member services, collect and verify critical information, administer health assessments, and process insurance or DME authorization requests accurately and efficiently. Strong proficiency in typing (60+ WPM), managing high-volume email inboxes, and delivering exceptional customer service to members and providers through clear, professional verbal and written communication is required. Candidates must also demonstrate polished business phone etiquette, strong attention to detail, and the ability to thrive in a fast-paced, service-oriented healthcare environment.

The work Schedule: Monday–Friday, 8:00 AM–5:00 PM CST.

Note: Texas residence is required due to occasional IN-PERSON performance improvement training or staff meet-up sessions, which are occasionally held at the Centene/Superior Health Plan Talent Hub offices.

• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.

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

Preferred Experience:

• 3+ years of healthcare administrative support experience in both inbound and outbound call center environments.
• Proven ability to coordinate member services, collect and verify critical information, administer health assessments, and process insurance or DME authorization requests accurately and efficiently.
• Strong personable communication, attention to detail, organizational, and time management skills are required.
• Ability to adapt to changing business needs with openness, flexibility, and professionalism.
• Proficient technology skills and direct experience working Microsoft Office Suite and Video Conferencing Applications – (MS Outlook, Word, M365 Copilot, Excel, PowerPoint, OneNote, Teams and ZOOM etc.)
• Must be able to work independently with minimal supervision.
• Experience working with government and state sponsored programs (i.e. Medicaid, Medicare, STAR Plus, Medicaid Waiver, etc)
• Bilingual English/Spanish skills are a plus, but not required

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