You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. **Applicants for this position must reside in the Reno County area as the role requires up to 50% local travel to visit members. Candidates are able to work remotely from their home the remaining time. The work schedule is Monday - Friday, 8am - 5pm Central.** Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. - Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome - Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care - Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members - Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans - Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs - Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met - Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators - May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners - Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits - Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner - Performs other duties as assigned. - Complies with all policies and standards. Education/Experience: Requires a Bachelor's degree and 2 – 4 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Pay Range: $27.02 - $48.55 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a highly motivated and customer-focused International Clinical Coordinator Specialist to assist our international individual customers in the United States. This role is critical in ensuring seamless access to healthcare services, guiding members toward appropriate clinical resources, and addressing affordability concerns. The ideal candidate will possess strong clinical acumen, excellent problem-solving skills, and the ability to navigate complex healthcare systems. This position requires fluency in English and one additional language to effectively support our diverse customer base. Key Responsibilities - Customer Support & Clinical Navigation - Serve as the primary point of contact for international customers in the US, assisting them with clinical inquiries and healthcare navigation. - Guide customers to the most suitable healthcare facilities and providers based on their medical needs. - Support members in understanding their benefits, available services, and access to care. - Affordability & Access Support - Assist customers in identifying cost-effective care solutions and alternative treatment options. - Provide education on available financial assistance programs, provider networks, and payment structures. - Work closely with internal teams to resolve billing and coverage-related concerns. - Coordination & Case Management - Collaborate with healthcare providers, other case managers, and internal teams to facilitate seamless care experiences. - Ensure timely follow-ups with members to address ongoing healthcare needs and concerns. - Maintain accurate and confidential records of customer interactions and resolutions. - Communication & Multilingual Support - Provide culturally competent and linguistically appropriate support to international customers. - Act as a liaison between customers, providers, and internal stakeholders to ensure clear and effective communication. - Continuous Improvement & Compliance - Identify trends in customer needs and recommend process improvements. - Stay updated on US healthcare regulations, international insurance policies, and emerging industry best practices. - Ensure compliance with all applicable laws, company policies, and confidentiality requirements. Qualifications - Education: Associate's degree or equivalent required; Bachelor’s degree in Nursing, Healthcare Administration, Social Work, or a related field preferred. - Experience: Minimum of 5 years in a healthcare, case management, customer service, or patient advocacy role. Previous experience working with international patients/customers is a plus. - Languages: Fluency in English and one additional language (e.g., Spanish, French, Portuguese, Arabic, etc.). Requirements - Strong knowledge of the US healthcare system, including provider networks and cost structures. - Excellent problem-solving and critical-thinking abilities. - Exceptional verbal and written communication skills. - Empathy, cultural awareness, and the ability to handle sensitive situations with discretion. - Proficiency in Microsoft Office and CRM systems. Benefits - Opportunity to make a meaningful impact by improving healthcare access for international customers. - Collaborative and dynamic work environment within a global organization. - Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs. - 401(k), company paid life insurance, tuition reimbursement. - A minimum of 18 days of paid time off per year and paid holidays.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Responsibility for initiating phone contact with discharged patients from specified units, conducting query on patient experience and recovery, and providing needed follow up to patients and/or family members. Coordinates patient responses requiring further intervention with appropriate Nurse Manager. Works independently and/or under indirect supervision of the Nurse Manager. - All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. - Conduct non–face-to-face post-discharge outreach calls to patients within the CMS-required timeframe. - Review discharge summaries, medication lists, and follow-up instructions prior to patient contact. - Medication reconciliation and coordination support. - Assess patient understanding of discharge plan, symptom management, and medication adherence. - Records patient responses and advice provided, documents any variations. Provides appropriate follow up as indicated by patient responses and needs. - Identify early signs of potential complications and escalate concerns to the provider or care team. - Schedule appointments directly with the patient’s primary care provider. - Coordinate with front desk and clinical teams to secure timely appointment availability. - Document all outreach attempts, patient interactions, and outcomes in the EHR according to Prisma Health and CMS requirements. - Provide/Reinforce education provided at discharge, including when to contact the provider versus seek emergency care. - Support readmission prevention efforts by ensuring appropriate follow-up and addressing barriers to care. - Review and address open care gaps (e.g., hypertension control, diabetes monitoring, preventive screenings, wellness visits). - Educate patients on the importance of completing overdue screenings or visits and assist in scheduling. - Collaborate with providers, care coordinators, and case management teams to ensure continuity of care. - Participate in team discussions and quality improvement initiatives related to department effectiveness and patient outcomes. - Maintain awareness of required documentation and billing requirements to ensure compliance. - Provide hypertension-focused education on home blood pressure monitoring, medication adherence, lifestyle modifications, and follow-up importance. - Assess and intervene for elevated blood pressure readings or medication concerns by escalating to the provider and facilitating appropriate follow-up. - Collects patient data and completes required forms with appropriate responses according to the unit standards; identifies patient's problems/needs and sets priorities; identifies problems requiring further referral and/or follow-up; observes and records latest diagnostic results; performs advanced nursing observations using critical thinking skills. - Develops a plan for follow up care based on nursing process, and which incorporate the plans of other disciplines and continuing or emerging care needs; include the patient/family in developing or revising plan. - Care provided conforms to accepted practice standards; provides correct telephonic care advice and other follow up instructions according to patient care standards; demonstrates understanding of age-related characteristics and needs of patients served; explains nursing procedures and discharge teaching in appropriate forms; evaluates care measures instituted; identifies situations that require immediate action and provides appropriate plan; understands and demonstrates respect for patient rights and confidentiality, and identifies mechanism for management of any ethical issues. - Performs other duties as assigned. Qualifications - Education - Associate degree in Nursing. Bachelor's degree in Nursing preferred. - Experience - One (1) year experience as a registered nurse. Requirements - In lieu of an associate’s degree in nursing (AD N), will accept an RN diploma or certificate with a current RN compact/multistate license recognized by the NCSBN Compact State or a license to practice as an RN in the state the team member is working. - Holds a current RN compact/multistate license recognized by the NCSBN Compact State or is licensed to practice as an RN in the state the team member is working. Company Description Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a vital member of our Enrollments team, the Clinical Outreach Specialist plays a crucial role in connecting with prospective clients and guiding them through our Enhanced Care Management (ECM) services. In this position, you will reach out to potential clients, educate them about our offerings, and facilitate their enrollment by assessing their needs and linking them with our care management team. The ideal candidate will be personable and professional in phone interactions, adept at quickly reviewing and understanding medical charts, and skilled in delivering person-centered care. You will need to prioritize tasks effectively to enhance client engagement and be driven to support individuals with complex care requirements. What you’ll do - Client Outreach: Engage with prospective clients and meticulously record all interactions in the Client Relationship Management (CRM) system. Daily responsibilities will include making 60-100 outbound calls to prospective clients. - Care Planning: Convey essential information and client preferences to the care team to facilitate personalized care planning. - Assessment Support: Assist clients in completing psychosocial assessments and developing care plans with clear, actionable goals. - Medical Chart Review: Review medical charts to document client needs and recommend appropriate interventions. - Evidence-Based Practices: Apply evidence-based practices, including Motivational Interviewing, Harm Reduction, and Trauma-Informed Care principles, in all client interactions. - Team Collaboration: Participate in weekly Team Operations Meetings to coordinate and optimize care delivery. Qualifications - Willing and able to work Monday through Friday 8:30am-5:00pm Pacific Time, with flexibility for potential evenings and weekends. - Active California Licensed Vocational Nurse (LVN) license, or Medical Assistant certificate issued by a recognized group, or Bachelor’s degree in a related field. - 3+ years of direct healthcare experience, ideally working with vulnerable populations. - Excellent oral and written communication skills are essential. - Positive interpersonal skills required for effective client engagement. - Comfortable with technology, including video conferencing, Google Workspace, Slack, and electronic health records. - Experience with Athena Health and Health Gorilla is a plus. - Prior experience in a remote role is important. You must have a quiet, secure workspace to ensure member privacy and be able to test your internet speed to ensure smooth application functionality. - Bilingual (English/Spanish) preferred. Benefits - Pay Range: $27-$30/hour. Pay for this position will be based on several factors, including, but not limited to: your prior experience and skills related to the position, geographic location, company needs, and current market demands. - Great humans deserve great benefits! At Vynca, full-time employees are eligible for benefits such as: medical, dental, and vision insurance, income protection benefits, flexible PTO, company holidays, 401k, and access to other wellness benefits. Additional Information - The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks. - Background Screening: A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment. - Job Description Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein. - Vaccination Requirement: Employees in patient, client, or customer-facing roles must be vaccinated against COVID-19 and influenza. Requests for religious or medical accommodations will be considered but may not always be approved. - Employment Eligibility: Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire. - Equal Opportunity Employer: At Vynca Inc., we embrace diversity and are committed to fostering an inclusive workplace. We value all applicants regardless of race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other protected group under federal, state, or local law.