Job Description

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.



Centene is seeking a Care Coordinator III for our Silver Summit Health Plan in Las Vegas, NV. This hybrid role requires the individual to work remotely and up to three days on-site at provider offices. The ideal candidate will be bilingual in English and Spanish, possess healthcare knowledge including HEDIS, and be skilled in member outreach and education regarding preventive screenings and available health resources.

Location:

Las Vegas, Nevada (Hybrid - Remote + 3 Days Onsite at Provider Offices)

Schedule:

Monday to Friday, 8:00 AM - 5:00 PM

Key Responsibilities:

Conduct outreach to members to provide education on preventive care and screenings. Assist members in accessing appropriate healthcare resources. Collaborate with provider offices and internal teams to support care coordination initiatives.

Ideal candidate:

Bilingual in English and Spanish (required). Background in healthcare, HEDIS, and preventive care best practices. Strong communication, outreach, and problem-solving skills. Must reside in the Las Vegas/Henderson, NV area.

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



Pay Range: $20.00 - $34.03 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, 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