****NOTE: This is a work-from-home, remote role with occasional travel (up to 10%) to our various Ohio offices for essential business meetings. This position supports Long Term Care (LTC) Care Coordination through activities such as member outreach and mailings, appointment scheduling and reminders, prescription coordination, and provider follow-up. Preference will be given to applicants with experience in one or more of the following areas: managed care, physician office or health system operations, healthcare administration, and medical terminology. Must reside in Ohio.

Additional Details:
• Line of Business: Buckeye Community Health Plan
• Department: MED-Case Management
• Schedule: 8am-5pm ET, with the potential for overtime, including evenings and weekends as needed ****

Position Purpose: Works with senior care management team to support 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. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits.

• 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 plans

• Develops in-depth knowledge of care management services including responding to some complex or escalated issues

• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care

• Performs service assessments/screening for members with some complex needs and documents the member’s care needs.

• Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed

• Works with care management team with triaging, adjusting, and escalating complex requests to management

• 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 cased organizations, and Disease Manager

• Provide education on benefits and resources available

• May assist with training and development needs

• Performs other duties as assigned.

• Complies with all policies and standards.

Education/Experience: Requires a High School diploma or GED.
Requires 2 - 4 years of related experience
 

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