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Long Term Care Enrollment Specialist

Company: Wellcare New Jersey
Location: Jersey City
Posted on: July 3, 2024

Job Description:

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.

  • Must reside in Essex, Union, and/ or Somerset County, NJ
  • Conduct home visit(s) to educate applicant, family and/or applicant's caregiver(s) or newly enrolled LTSS members on program benefits and design.
  • Identify applicant's health needs and complete medical assessment of applicant.
  • Utilize WellCare designated criteria along with clinical knowledge to develop personalized plan of care.
  • Initiate direct communication with health care providers involved in the care of the applicant to obtain complete and accurate information needed to complete plan of care.
  • Negotiate appropriate care plan based on health assessments with health care providers, member and caregiver.
  • Collect information concerning eligibility, provider status, benefit coverage, and coordination of benefits.
  • Input visit and assessment data into systems.
  • Adhere to all HIPPA standards and confidentiality requirements.
  • Transition member to assigned care manager as indicated via verbal communication.
  • Performs other duties as assigned.Additional Responsibilities: * Valid Drivers license may be requiredMust reside in Essex, Union, and/ or Somerset County, NJCandidate Education: Required An Associate's Degree in Nursing

    Preferred A Bachelor's Degree in Nursing or related fieldCandidate Experience: Required 4+ years of experience in A clinical acute care setting, preferably in home health and/or geriatrics.

    Required Other Current case management experience:
    Preferred Other Public speaking and health education experience Licenses and Certifications: A license in one of the following is required: Required Licensed Registered Nurse (RN)Pay Range: $54,000.00 - $97,100.00 per yearCentene 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.

Keywords: Wellcare New Jersey, Jersey City , Long Term Care Enrollment Specialist, Other , Jersey City, New Jersey

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