Long Term Care Enrollment Specialist

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.
 

Position Purpose: Assess applicants in the community for eligibility or following enrollment in our Managed Long Term Care program provide overview of program's benefits to member, family member(s) and care giver(s). Provides overview of program's benefits to applicant, family member(s), care giver(s). Complete medical assessment of applicant and develop personalized plans of care. Complete Reassessment as needed of our members in the Managed Long term Care Program. Transitions newly onboarded members to their assigned care manager for ongoing care management and support.

• Conduct home visit(s) to educate applicant, family and/or applicant’s caregiver(s) or newly enrolled LTSS members on program benefits and design.
• Identify applicant’s health needs and complete medical assessment of applicant.
• Utilize WellCare designated criteria along with clinical knowledge to develop personalized plan of care.
• Initiate direct communication with health care providers involved in the care of the applicant to obtain complete and accurate information needed to complete plan of care.
• Negotiate appropriate care plan based on health assessments with health care providers, member and caregiver.
• Collect information concerning eligibility, provider status, benefit coverage, and coordination of benefits.
• Input visit and assessment data into systems.
• Adhere to all HIPPA standards and confidentiality requirements.
• Transition member to assigned care manager as indicated via verbal communication.
• Performs other duties as assigned.Additional Responsibilities: * Valid Drivers license may be required

Candidate Education: Required An Associate's Degree in Nursing

Preferred A Bachelor's Degree in Nursing or related fieldCandidate Experience: Required 4+ years of experience in A clinical acute care setting, preferably in home health and/or geriatrics.

Required Other Current case management experience:
Preferred Other Public speaking and health education experience Licenses and Certifications: A license in one of the following is required: Required Licensed Registered Nurse (RN)

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.