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Program Coordinator I -- Remote Available

Centene

Location: USA-Florida-Tampa, USA-Florida-Miami, USA-Florida-Orlando
Type: Remote
Posted on: October 20, 2021
This job is no longer available from the source.
Submission for the position: Program Coordinator I -- Remote Available - (Job Number: 1254629)
https://centene.taleo.net/careersection/jobdetail.ftl?job=1254629&lang=en
Program Coordinator I -- Remote Available
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to 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.
Additional Details:
*Department: Children's Medical Services
*Location: Possible work-from-home available. Applicant should reside near a Florida Centene office in case they have connectivity issues at home.
*Main Tasks: Outbound calls to our CMS Members that are currently not enrolled in Case Mangement. Make referrals to Case Management when needed.
Shift: 9-6 PM EST or 10-7 PM EST. No weekends.
Our Comprehensive Benefits Package:
• Flexible work solutions including remote options, hybrid work schedules and dress flexibility
• Competitive pay
• Paid Time Off including paid holidays
• Health insurance coverage for you and dependents
• 401(k) and stock purchase plans
• Tuition reimbursement and best-in-class training and development
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.
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.
Medical Management
USA-Florida-Tampa
USA-Florida-Miami, USA-Florida-Orlando
Sunshine State Health Plan
Schedule: Full-time Location(s): USA-Florida-Tampa