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.
Bachelor’s degree in social work, psychology, gerontology, human services related field or equivalent experience with 2+ years of case management experience or LPN with 4+ years of case management experience.
Licenses/Certifications: Current state driver’s license.
• Complete assessments with member/caregiver/provider 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/providers through member face to face
• Authorize and coordinate referral for services
• Ensure provider services are delivered without gaps and identifies 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.
• Assists member with filing and resolution complaints and appeals
Centene is sensitive to the needs of individuals and families enrolled in government-assisted health programs. The company provides managed...