You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
THIS POSITION IS REMOTE/WORK FROM HOME. QUALIFIED APPLICANTS WILL RESIDE IN EASTERN TIME ZONE HOUR STATE AND BE ABLE TO WORK MONDAY - FRIDAY, 8AM - 5PM.
Position Purpose: Provide non-medical administrative support to service coordination and case management team.
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Assign new participants to the Service Coordination team following Centene policies and procedures
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Maintain appropriate records, files, and documentation. Distribute emails and faxes to providers
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Enter new and modifications to authorizations into systems
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Perform tasks necessary to promote participant compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.
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Screen for eligibility and benefits. Screen members by priority for assessment and refer to appropriate team following established workflows
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Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produce and mail routine letters and program educational materials
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Provide support through inbound and outbound calls. Triage, adjust, or escalate requests to management.
- Implement LTSS services for our Participant population while ensuring our Providers are appropriately paid.
- Authorization building and modification is needed on a daily basis as new assessments and subsequent decisions are rendered.
- Drafting and sending approval letters for various LTSS services. We must mail written notices to participants within 2 days of the decision as part of our CHC contract agreement.
- Act as a communication liaison between multiple departments to resolve Authorization matters as they arise and supports any ad-hoc project needs that come to the plan.
Education/Experience: High school diploma or equivalent. Bachelor’s degree preferred. 0-2 years of healthcare experience. General computer knowledge including MS Office Excel, Word, and Outlook. Familiarity with medical terminology preferred.Pay Range: $15.29 - $26.20 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.