Centene Corporation ยท 1 day ago
Quality Care Member Advocate
New York, United States
Full-time
Hybrid
Entry, Mid Level
$27.02/hr - $48.55/hr
2+ years expCentene Corporation is transforming the health of communities by focusing on individual members. The Community Quality Liaison serves as a vital link between members and the healthcare system, emphasizing community engagement, member education, and collaboration to improve health outcomes.
Hospital & Health Care
Responsibilities
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 that may prevent members from accessing preventive or follow-up care, and facilitate care coordination
Serve as a member advocate by helping individuals navigate complex healthcare and social service systems. Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements, ensuring members receive the support needed to close care gaps and maintain continuity of care
Collaborate with providers to share quality performance data (e.g., HEDIS, 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 the appropriate systems
Partner with internal departments (e.g., Quality, Care Management, Provider Relations) to align efforts and improve member outcomes
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 to improve member engagement and health outcomes
Serve as a community ambassador, building relationships with local organizations and stakeholders
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
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
Preferred
LCSW- License Clinical Social Worker 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
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Beth Johnson
President and CEO, Coordinated Care
Clyde White
President & CEO (New Hampshire Healthy Families)
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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