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Customer Service Representative

Company: WellCare of North Carolina
Location: Chinquapin
Posted on: May 3, 2021

Job Description:

You could bethe onewho changes everything for our over 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national Fortune 50 and rapidly growing organization, our mission is fueled by exceptional talent. About Us:We are revolutionizing the world of healthcare through a strengthened local presence and exceptional customer service. Our team of passionate professionals ensures our members receive individualized care tailored to their needs. We are turning visions into action and challenging what is possible to support the healthcare of 1 in 15 individuals. About You:You are a highly collaborative, customer focused professional driven to make a difference and change the face of healthcare. You thrive in a supportive, result-oriented community and are committed to the relentless pursuit of continuous growth. You excel in fast-paced environments and willing to push outside your comfort zone. You are ready to find your purpose at work.The RoleWe are transforming the lives of the people we serve. Care Managers are the heart of what we do and play a critical role in the member experience. Your mission will be to help our members achieve their optimal health by supporting them through our high quality healthcare approach. Long Term Services and Supports Program (LTSS)The goal of the LTSS Program is to support members to live in the lowest acuity setting that effectively meet their personal, clinical and safety needs; deliver expanded community services to support member needs beyond acute care. Care managers interact with members both telephonically and face-to-face, depending on the needs of the member and their level of care needs.Care managers identify member needs through various standard assessments; care managers will also develop an individualized care plan for each member. You, as the LTSS CM acts as an advocate and liaison for your member. You communicate with the member, their providers, their community services, and their support team to ensure that the member's needs are met. LTSS benefits include those used by members of all ages with functional limitations and chronic illnesses. LTSS helps those needing assistance to perform routine daily activities (e.g., bathing, dressing, meal preparation, administering medications).As a Care Manager you will:Conduct home/facility visit(s) for comprehensive health re-assessments regarding clinical, behavioral and home safety requirements on existing members (once it is safe to do so).Identify applicant's health needs and complete medical assessment of applicant.Track assessment schedule and update assessments in a timely manner.Initiate direct communication with health care providers involved in care of the applicant to obtain complete and accurate information as needed.Collect information concerning ongoing eligibility.Coordinate with Care Management team and provide updates regarding member health status.Input visit(s) and assessment data into systemsAdhere to all HIPPA standards and confidentiality requirements.Perform other duties as assigned.Additionally, you'll need:Licensed Registered Nurse (RN)2+ years of experience in a clinical acute care setting, preferably in home health and/or geriatrics, Long term support services, Managed care preferredValid Drivers license may be required**This positionis primarily remote, some office attendance required (i.e. staff meetings) and field based that will require home visits, therefore; candidates must be located in or near Pittsboro, Olive Hill, Roxboro, Carrboro, Chapel Hill, Mebane, Burlington, or Yanceyville**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.

Keywords: WellCare of North Carolina, Jacksonville , Customer Service Representative, Other , Chinquapin, North Carolina

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