Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.

You could be the one who changes everything for our 26 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.

PLEASE NOTE: THIS POSITION IS HYBRID REMOTE WITH FIELD VISITS. APPLICANTS SHOULD BE LOCATED WITHIN 25 MINUTES OF THE FOLLOWING LOCATIONS: SKOKIE, MORTON GROVE AND NILES, IL AREA (NEAR THE FOLLOWING COOK COUNTY ZIP CODES: 60076,60077,60203, 60053, 60646, 60714). THIS POSITION OFFERS CASE MANAGEMENT SERVICES TO WAIVER AND DISABILITY WAIVERS MEMBERS UNDER ILLINOIS HEALTH PLAN.

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

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.
 

Additional Details:
• Department: Illinois Health Plan / MED-Case Management
• Caseload: Waiver and Disability Waivers members under Illinois Health Plan.
• Territory: WIthin 25 minutes of the following locations: Skokie, Morton Grove and Niles, IL area (near the following Cook county zip codes: 60076,60077,60203, 60053, 60646, 60714). Work-from-home case management role with local home visits. Must reside in the above mentioned area.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

All your information will be kept confidential according to EEO guidelines.