Care Coordinator IV

About the role

The Care Manager will provide care management and coordination for pediatric members from birth through age five. Responsibilities include conducting assessments and screenings, developing care plans, and connecting members and their families with appropriate resources.

This position supports the Pediatric Care Management team.

The role follows a standard schedule. Flexible scheduling may be available after the employee is hired and completes training.

Candidates must reside in North Carolina.

Position Purpose

Leads the care coordination team to support care management activities to assigned members to ensure appropriate services are delivered by providers and ensure continuity of care across services. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for the member and interacts with members by performing member outreach telephonically or through home-visits.

• Leads and oversees outreach to members via phone or home visits to engage member and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for both the member and provider 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
• Provides continuous support and insight and serves as support on various highly complex member and/or provider inquiries, requests, or concerns related to care plans/service plans
• Develops advanced 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
• May oversee service assessments/screenings for members with complex needs and documents the member’s care needs
• Documents, maintains, and reviews member records in accordance with state and regulatory requirements and provide to providers as needed
• Works with care management team with triaging, adjusting, and escalating highly 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 based 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 4+ years of related experience

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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.