Program Coordinator I
Company: Home State Health Plan
Location: Kennett
Posted on: June 25, 2022
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Job Description:
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. 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 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 paid holidays Health insurance coverage for you
and 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: Home State Health Plan, Memphis , Program Coordinator I, Other , Kennett, Tennessee
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