Program Coordinator I
Company: Corporate
Location: Ladonia
Posted on: May 28, 2023
|
|
Job Description:
You could be the one who changes everything for our 26 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: Assist in activities related to the medical and
psychosocial aspects of utilization and coordinated care.
--- Initiate authorization requests for output or input services in
keeping with the prior authorization list. Research claims inquiry
specific to the department and responsibility.
--- Perform tasks necessary to promote member compliance such as
verifying appointments, obtaining lab results. Assess and monitor
inpatient census.
--- Screen for eligibility and benefits. Identify members without a
PCP and refer to Member Services. Screen members by priority for
case management (CM) assessment. Perform transition of care duties
to include but not limited to, contact the member's attending
physician, member or medical power of attorney, other medical
providers (home health agencies, equipment vendors) for information
pertaining to special needs.
--- Coordinate services with community based organizations. Attend
marketing and outreach meetings as directed to represent the plan.
Produces and mails routine CM letters and program educational
material.
--- Data enter assessments and authorizations into the system.
Education/Experience: High school diploma or equivalent. 2-3 years
managed care setting, medical office or facility setting with
demonstration of medical administration duties. Thorough knowledge
of customer service, utilization review or claims processing
practices in a managed care environment and operation of office
equipment such as a personal computer. Knowledge of medical
terminology.
For Illinois Youth Care contract: Required Education/Experience -
Bachelor's Degree in nursing, social sciences, social work, or a
related field. 1 year supervised clinical experience in a human
services field. For Illinois YouthCare plan only: Candidates are
required to live within the specified region.
For Oregon plan only: A valid driver's license is required.
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.
Keywords: Corporate, Allen , Program Coordinator I, Other , Ladonia, Texas
Click
here to apply!
|