Patient Care Advocate

🔥 15 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – 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 and provide HEDIS and coding education • Support quality improvement interventions and provider audits • Assist in resolving deficiencies affecting compliance with State and Federal HEDIS standards • Conduct telephonic outreach and health coaching to members identified as needing preventive services • Provide members and families with education about care gaps and barriers to care in provider offices • Schedule doctor appointments and arrange transportation, follow-up appointments, wraparound services, and community resources • Act as a liaison and member advocate between members or families, physicians, facilities, and agencies • Serve as the face of WellCare in embedded provider practices • Advise provider practices on HEDIS measures and HEDIS ICD-10/CPT coding in accordance with NCQA requirements • Assess provider performance data and identify opportunities for improvement • Collaborate with Provider Relations on Quality, Risk Adjustment, Operations, claims, and encounters • Document all member-contact actions • Interact with departments including customer service 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 authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Must be located in Eastern Tennessee • 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 the equivalent-work-experience pathway • 2+ years of work experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment • Preferred: Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Certified Social Worker (C-SW), Licensed Social Worker (LSW), or Licensed Registered Nurse (RN)

🏖️ Benefits

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