You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

Maintain collaborative relationships with Health & Family Services, government agencies, community resource and advocacy groups, to build additional community support for current and potential enrollees.

• Work effectively with internal staff, staff at local and state government agencies, and with contracted health plans and regulatory/accreditation entities to develop and implement processes to better serve enrollees

• Establish and maintain key community relationships throughout State

• Develop and implement appropriate policy and procedure to ensure health plan staff are able to facilitate enrollee and provider needs through entire case management cycle

• Communicate, identify, resolve, and prevent care problems, with other systems of care, as well as government and community agencies.

• Monitor and report on achievement of committed action plans

• Facilitate on-going communication between the health plan, provider community, and Health & Family Services

• Coordinate outreach activities to identify enrollees needing care within the urban and rural populations

• Compile and review reports on work function activities for statistical, financial and process improvement tracking purposes to identify trends, assist in financial forecasting, and make recommendations to management

• Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives

• Ensure compliance with State law and regulations

• Additional responsibilities for LHCC (LA) only for DOJ positions:

• Will serve as the LHCC representative for this program with the state

• Participate in MCO workgroup meetings to review and make appropriate changes to the LDH-approved guidance documents for this program to include but not limited to: agency standard operating procedure, training guidelines, assessment tools, care plan templates, and follow-up progress notes.

• Serve as the point of contact for our delegated PASRR vendor

• Contribute to monthly reporting for PASRR submitted to LDH

• Perform quality checks on PASRR documentation submitted by vendor before sending to LDH

• Ensure timelines for PASRR completion are adhered to

• Collaborate w/ LDH/OBH PASRR liaison

• Attend state transition coordination meetings as needed

• Other duties as assigned

Highly Preferred Experience & Skills

• Medi-Cal/Medicaid and managed healthcare
• Strong relationship builder
• Public speaking and presenting in a public setting
• Strong communication skills
• 10% Field Based Travel and 90% Office/Hub
• CA Residents Education/Experience:

Bachelor’s degree in Social Work, Nursing, or related field. 5+ years of social services or advocacy experience preferably in Medicaid environment.

License/Certification:

LCSW or RN license preferred.

Pay Range: $27.02 - $48.55 per hour

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