Our Ability Jobs

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: 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.

• Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources

• Provide assistance to members and/or providers regarding website registration and navigation

• Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application

• Process written customer correspondence and provide the appropriate level of timely follow up

• May coordinate member transportation and make referrals to other departments as appropriate

• Maintain performance and quality standards based on established call center metrics including turn-around times

• Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment

• Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction

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 preferred.

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.

TITLE: Service Coordinator I

LOCATION: Various, Texas

REQNUMBER: 1426257