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.

+ Must reside in Raleigh or Durham, NC

+ Manages an active caseload based on state mandated ratios according to residential setting, case intensity and acuity.

+ Partners effectively with the PCP, Specialist, member, member’s family and interdisciplinary care teams (ICT) to develop a Person Centered Care Plan.

+ Utilizes clinical knowledge and expertise to craft strategies aimed at member education to support self-management and achieve optimal health outcomes

+ In partnership with the member, family, physician(s), ICT and other providers, assesses short and long-term member needs, evaluates the need for supportive e services and establishes member driven care management objectives.

+ Responsible for coordination of service authorizations (i.e. meals, transportation, activities of daily living).

+ Performs clinical interventions such as education on prescribed medication treatment regimens and counseling.

+ Ensures comprehensive assessments and person-centered care plans are completed within required time frames and utilizes clinical knowledge and expertise to assess options for care including use of benefits and community resources

+ Acts as liaison and member advocate between the member/family, physician and facilities/agencies.

+ Maintains accurate reports and manages the integrity of care management activities in the electronic care management system, using clinical guidelines.

+ Educates on and coordinates community resources, to include medical, behavioral and social services.

+ Applies care management standards and maintains HIPAA standards and confidentiality of protected health information.

+ Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.

+ Participates in performance improvement activities.

+ Performs special projects as assigned.

+ Additional Responsibilities:

+ Performs other duties as assigned

+ Complies with all policies and standards

Must reside in Raleigh or Durham, NC

**Education/Experience:**

**Required Other For NC, LTSS CM applicants must meet the following requirements:** Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience;

Prior experience with social work, geriatrics, gerontology, pediatrics, or human services.

RN or LCSW/LCSW-A required

Pay Range: $25.97 - $46.68 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.