Centene Corporation Service Coordinator II (McAllen TX area) in McAllen, Texas
Position Purpose: Determine needs and eligibility of members for various services through field-based collaboration with medical, behavioral, and social support staff. Conduct screening and risk assessment interventions per program guidelines.
Conduct in-home face to face member assessments and telephonic outreach
Document assessments and contacts, develop and approve service plans, and ensure authorizations are completed
Conduct follow-up contacts or in-person visits to determine if services meet member s needs
Assess member s medical, safety and support service needs and coordinate the delivery of services
Provide education related to member s health condition and care
Assist with modification and management of care plans under the direction of Registered Nurse in conjunction with member, medical consenter or caregiver, Department of Family and Protective Services caseworker and family, if applicable, as well as the managing physician
Maintain case record documents and enter information in an automated system, establishing a record for each member receiving services
Coordinate member care through collaboration with community outreach and member advocates, assigned service coordinators, and/or case managers
Educate providers and community resources on program components and available support services
Educate members to foster compliance with program and positively impact outcomes
75% travel required
Education/Experience: Bachelor s degree in Social Work, Health Services, Behavioral Science or related field, or equivalent experience. 2 years of experience in a managed care environment or working with people with disabilities and vulnerable populations who have chronic or complex conditions. Other state specific requirements may apply.
Licenses/Certifications: LPN, LVN, LCSW or RN preferred. Current state driver s license.
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.
Job: Clinical & Nursing
Organization: Superior HealthPlan
Requisition ID: 1073818