You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Applicants must physically reside in the state of Texas. Position requires up to 15% local travel to offices.

Position Purpose: Works with care management team on 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.

• 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 experienced 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 in-depth 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

• Applies in-depth knowledge of care management support activities including care plans and community resources

• 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

• Works with care management team on escalating requests and inquiries to management

• 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

• May support training of new hires

• 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

Preferred Work Experience:

·         4+ years of experience with internal auditing, data mining, creating job aides and reports, and collaborating with regulatory compliance stakeholders for government sponsored programs (i.e. STAR Health, STAR Plus, STAR Kids,).

Business Analysis Knowledge:

·         2+ years of experience engaging and partnering with Program Support Units, HHSC, and Service Coordination providers and clinical staff to conduct regulatory audits and data analysis

·         Must have strong analytical and problem-solving skills.

·         Role requires strong attention to detail, organizational and time management skills

Proficient Computer Skills and Search Navigation:

·         Moderate proficiency in Excel skills (i.e. using Filters, V look-ups, Pivot Tables, Sorting data, etc.) is required - 90% of role duties and responsibilities is working in Excel

·         Proficient computer skills, knowledge, and experience working within large databases or provider information systems

·         Microsoft Office applications (Excel, Outlook, Word) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)

·         Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required.

Effective Customer Service:

·         Skilled to communicate with all levels of management, internal and external customers

·         Role requires excellent customer service and emotional intelligence skills

·         Ability to collaborate with team members and work independently

Effective Business Communication:

·         Skilled in communicating with technical and business constituencies

·         Must be highly adaptable/flexible to changes and skilled at learning new processes

Requires background check - Texas Dept Family Protective Services

Pay Range: $19.62 - $33.36 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.