[Hiring] Patient Care Advocate @Centene Corporation

Role Description

This position involves working with members and providers to close care gaps, ensure barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction.

• Collaborate with providers to improve HEDIS measures and provide education for HEDIS measures and coding.
• Support the implementation of quality improvement interventions and audits in relation to plan providers.
• Assist in resolving deficiencies impacting plan compliance with State and Federal standards for HEDIS.
• Conduct telephonic outreach while embedded in providers' offices to members needing preventive services.
• Provide education to members regarding care gaps during medical appointments.
• Schedule doctor appointments on behalf of practitioners and assist members with wraparound services.
• Maintain confidentiality of business and protected health information.
• Act as a liaison and member advocate between members/families, physicians, and facilities/agencies.
• Advise and educate provider practices on appropriate HEDIS measures and coding in accordance with NCQA requirements.
• Assess provider performance data to identify and strategize opportunities for improvement.
• Collaborate with Provider Relations to improve provider performance in Quality, Risk Adjustment, and Operations.
• Conduct face-to-face education with members and their families about identified care gaps.
• Arrange transportation and follow-up appointments for members as needed.
• Document all actions taken regarding member contact.
• Interact with other departments to resolve member issues.
• Refer to case or disease management as appropriate.
• Complete special assignments and projects instrumental to the department's function.
• Perform other duties as assigned.
• Comply with all policies and standards.

Qualifications

• Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field or equivalent work experience (total of 4 years required).
• 2+ years of experience in direct patient care, social work, quality improvement, or health coaching preferably in a managed care environment.

Requirements

• This position is fully remote and open to candidates currently residing in Michigan.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules