LTSS Care Navigator

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.

NOTE : This is a hybrid-remote role with 50% travel into member homes near the Hoffman Estates & Schaumburg area of Cook County, Illinois.

We are seeking applicants who reside within 30 minutes of this area.

Position Purpose : Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.

May develop or assist with developing personalized service care plans / service plans for long-term care members and educates members and their families / caregivers on services and benefits available to meet member needs.

• Evaluates the needs of the member, the resources available, and recommends and / or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans / service plans and works to identify providers, specialist, and / or community resources needed for long-term care
• Coordinates as appropriate between the member and / or family / caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families / caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans / service plans, member status and outcomes, as appropriate, and provides recommendations to care plan / service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
• Provides and / or facilitates education to long-term care members and their families / caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards

Education / Experience : Requires a Bachelor's degree and 1 year of related experience.

Physically Disabled / Elderly

Candidate must meet one of the 3 following criteria :

1. RN licensed in Illinois.

2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as : Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services / Social Work or Sociology.

3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

Additional Details :

• Department : Long Term Care / / MED-Case Management
• Caseload : Elderly and Physical Disability waiver members over 18 years old
• Territory : Near the Hoffman Estates & Schaumburg area of Cook County, Illinois. Remote work-from-home case management role with local home visits.

Must reside in or be willing to relocate to the above mentioned area.

Pay Range : $22.07 - $37.25 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.