Plan Design Coordinator jobs in Racine, WI

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

****NOTE: This role serves aging and disability waiver members including a subset of special needs children (SNC). It is a hybrid-remote role with 50% travel into member homes within 30 minutes of the following cities in Lake and McHenry County: Ringwood, Round Lake, Round Lake Beach, Round Lake Heights, Round Lake Park, Wonder Lake, or McHenry. Preference will be given to applicants who (1) reside with 30 minutes of these areas, (2) have a bachelors degree and (3) at least 1 year of supervised clinical experience in a human-services field. ****

Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination.

• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development
• Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact
• Authorize and coordinate referral for services
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care
• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services
• Assist member with filing and resolving complaints and appeals
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor’s degree or Registered Nurse License and 2 years of care management experience, Licensed Practical Nurse and 4 years of care management experience, or 6 years of care management experience. Home health, discharge planning, or long term care experience preferred.

Licenses/Certifications: Valid driver's license. LPN or RN preferred.

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly:
Candidate must meet one of the 3 following criteria:

• 1. RN licensed in Illinois.
• 2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
• 3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

****Additional Details:

• Department: Long Term Care // MED-Case Management
• Caseload: Elderly and Physical Disability waiver members over 18 years old
• Territory: within 30 minutes of the following cities in Lake and McHenry County: Ringwood, Round Lake, Round Lake Beach, Round Lake Heights, Round Lake Park, Wonder Lake, McHenry. Remote work-from-home case management role with local home visits. Must reside in or be willing to relocate to the above mentioned area.****

Pay Range: $22.36 - $38.07 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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.

Job Type: Full-time

Pay: $21.93 - $37.30 per hour

Benefits:

• 401(k)
• 401(k) matching
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Employee stock purchase plan
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Opportunities for advancement
• Paid sick time
• Paid time off
• Paid training
• Parental leave
• Prescription drug insurance
• Professional development assistance
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No weekends

Work setting:

• Hybrid work

Education:

• Bachelor's (Required)

Experience:

• care management: 2 years (Required)

License/Certification:

• Illinois driver's license (Required)
• Illinois RN or LPN license (Preferred)

Ability to Relocate:

• Round Lake Beach, IL 60073: Relocate before starting work (Required)

Work Location: Hybrid remote in Round Lake Beach, IL 60073