Service Coordinator I
Posted on: 19 Jan 2021
Lubbock, TX
Job Description
Position Purpose:
Provide support to medical, behavioral and social support staff to determine needs, eligibility and services for members. Conduct screening and risk assessment interventions per program guidelines.
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* Identify special needs members through the completion of health screens and other resources.
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* Work with community outreach/member advocates to coordinate member care.
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* Educate providers and community resources on program components and available support services.
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* Educate members with special needs to foster compliance with program and positively impact outcomes.
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* Conduct site visits as appropriate for programs and provide support to other special programs.
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* Assist with modification and management of care plans under the direction of a Registered Nurse in conjunction with member, medical consenter, caregiver, caseworker and family, if applicable, as well as the managing physician.t
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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 who have disabilities and/or with vulnerable populations who have chronic or complex conditions. Other state specific requirements may apply.
Licenses/Certifications: LPN, LVN or LCSW is preferred,but not required.
Preferred Experience: Experience providing health assessments, working in a physician's office, social services, healthcare, or managed care setting. Outbound call center experience within health insurance or healthcare setting is preferred. Professional phone etiquette and listening skills is required. Proficient computer skills and experience working within large databases and/or provider information systems and Microsoft Office applications.
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.
WellCare
Tampa, FL
WellCare Health Plans, Inc. provides government-sponsored managed care services. The company operates in three segments: Medicaid Health Plans, Medicare Health Plans, and Medicare Prescription Drug Plans (PDPs). The Medicaid Health Plans segment offers plans for beneficiaries of temporary assistance for needy families, supplemental security income, and aged blind and disabled residents; and other state-based programs, such as children's health insurance programs and long-term services and supports programs for qualifying families who are not eligible for Medicaid.
The Medicare Health Plans segment provides Medicare, a federal program that provides eligible persons aged 65 and over, as well as some disabled persons with a range of hospital, medical, and prescription drug benefits; Medicare Advantage, a Medicare’s managed care alternative to the original Medicare program, which offers individuals standard Medicare benefits directly through Centers for Medicare & Medicaid Services; and coordinated care plans that are administered through health maintenance organizations and require members to seek health care services and select a primary care physician from a network of health care providers.
The Medicare PDPs segment provides Medicare part D PDP plans to Medicare-eligible beneficiaries. Its PDP plans offer national in-network prescription drug coverage, including a preferred pharmacy network. As of December 31, 2018, the company served approximately 5.5 million members in the United States. WellCare Health Plans, Inc. was founded in 1985 and is headquartered in Tampa, Florida.
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IndustryHealthcare
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No. of Employees12, 000
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Website
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Jobs Posted917
