Quality Care Advocate

🔥 14 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $27 - $48 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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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

• Serve as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps • Conduct outreach to members in the community to identify care gaps and connect them with appropriate healthcare services and resources • Perform home visits or community-based assessments to evaluate member needs and identify social determinants of health • Facilitate care coordination • Help members navigate complex healthcare and social service systems • Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements • Collaborate with providers to share quality performance data, including HEDIS and CAHPS, and support improvement initiatives • Educate members on preventive care, chronic condition management, and available community resources • Document member interactions, care gap closures, and referrals in appropriate systems • Partner with Quality, Care Management, Provider Relations, and other internal departments • Monitor and report on outreach effectiveness and care gap closure metrics • Maintain compliance with state and federal regulations and organizational policies • Participate in seasonal campaigns and quality initiatives • Build relationships with local organizations and stakeholders as a community ambassador • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Must reside in the state of Texas • Bachelor's Degree Social Work, Public Health, Nursing, or related field; or equivalent experience required • 2+ years in community health or healthcare quality required • Experience working with health plan members and navigating community resources required • Familiarity with Medicaid / Medicare programs and quality measures (e.g., HEDIS) required • Strong communication and interpersonal skills • LCSW - Licensed Clinical Social Worker preferred • RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred

🏖️ 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