Care Management Support Coordinator IV - Team Lead

Position Purpose: Leads the care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues for care plan-related questions and documents member records in accordance with current state and regulatory guidelines.

• Leads and guides member outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service
• Provides ongoing support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
• Applies advanced knowledge of assigned health plan(s) activities and resources
• Serves as the front-line support on various highly complex member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols
• Works with care management team to identify process improvements on administrative care management activities and provide recommendations
• Applies advanced knowledge of care management support activities including care plans and community resources
• Performs team member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
• Works with care management team on escalating very complex requests and inquiries to management
• Documents and maintains all non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
• Contributes to the development of education and training programs
• Other duties or responsibilities as assigned by people leader to meet the member and/or business needs
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a High School diploma or GED AND 4+ years of related experience

Preferred Experience:

• 2+ years of care coordination experience supporting diverse populations, including children, adolescents, adults, and older adults
• Experience with, or working knowledge of, PSON and MNSF workflow processes
• 2+ years of experience with STAR Health, STAR Kids, STAR+PLUS, Duals, Medicaid, and/or Medicare programs
• Strong documentation skills with demonstrated audit performance in TruCare Cloud
• Demonstrated professionalism, diplomacy, adaptability, and attention to detail in a fast-paced environment
• Proficiency with Microsoft Office Suite, including Excel, OneNote, PowerPoint, and Outlook
• Excellent problem-solving, organization, time management, and communication skills
• Ability to adapt quickly to changing business priorities while maintaining flexibility and professionalism
• Ability to communicate data, findings, and recommendations clearly to cross-functional stakeholders

Note: This position requires a Texas DFPS background check

Pay Range: $22.94 - $38.79 per hour

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.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act