Patient Care Advocate

🔥 16 hours ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $27 - $48 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Work with members and providers to close care gaps and remove barriers to care • Improve member and provider experience through outreach and face-to-face interaction • Collaborate with providers in the field to improve HEDIS measures • Educate provider practices on HEDIS measures and HEDIS ICD-10/CPT coding • Support quality improvement interventions and audits related to plan providers • Assist in resolving deficiencies affecting compliance with State and Federal HEDIS standards • Conduct telephonic outreach and health coaching to members • Conduct face-to-face education with members and families in provider offices • Schedule doctor appointments and arrange transportation and follow-up appointments • Connect members with community-based resources and affinity programs • Act as liaison and member advocate between members/families, physicians, and facilities/agencies • Serve as WellCare representative in embedded provider offices • Assess provider performance data and identify opportunities for improvement • Collaborate with Provider Relations on Quality, Risk Adjustment, Operations, claims, and encounters • Document all member-related contact actions • Interact with customer service and other departments to resolve member issues • Refer members to case or disease management as appropriate • Complete special assignments and other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Must be located in Arizona, Maricopa County • Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future • Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field, or equivalent work experience • A total of 4 years of experience required for the position when using equivalent work experience • 2+ years of work experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment • Bilingual in Spanish highly preferred • One of the following preferred: Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Certified Social Worker (C-SW), Licensed Social Worker (LSW), or Licensed Registered Nurse (RN) • Ability to maintain confidentiality of business and protected health information • Knowledge of HEDIS measures and ICD-10/CPT coding in accordance with NCQA requirements

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity