Patient Care Advocate

Centene Corporation

. Work with members and providers to close care gaps and remove barriers to care .

Posted 10/16/2026full-timeKalamazoo • Michigan • United StatesJuniorMid-Level💰 $27 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in HEDIS measures and coding, along with strong skills in member advocacy and care coordination. Proficient in quality improvement initiatives and effective communication with healthcare providers and members.

Highest-signal resume keywords

HEDIS Measures KnowledgeHealth Coaching ExperienceDirect Patient Care ExperienceQuality Improvement SkillsLicensed Practical Nurse (LPN) or Licensed Social Worker (LSW)

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

HEDIS ICD-10 CodingPatient CareQuality ImprovementHealth CoachingData AssessmentCompliance StandardsDocumentationTelephonic OutreachFace-to-Face EducationCommunity Resource Connection

Soft Skills

Interpersonal CommunicationAdvocacyCollaborationProblem SolvingConfidentiality Maintenance

Certifications & Qualifications

Licensed Practical Nurse (LPN)Licensed Master Social Work (LMSW)Certified Social Worker (C-SW)Licensed Social Worker (LSW)Licensed Registered Nurse (RN)

Industry Keywords

Managed CareHealthcarePublic HealthSocial WorkHealth AdministrationPatient AdvocacyCare GapsBarriers to CareProvider RelationsState and Federal Standards

About the role

Key responsibilities & impact

Work with members and providers to close care gaps and remove barriers to care
Improve member and provider experience through outreach and face-to-face interaction
Collaborate with providers in the field to improve HEDIS measures
Educate provider practices on HEDIS measures and HEDIS ICD-10/CPT coding
Support quality improvement interventions and provider audits
Assist in resolving deficiencies affecting compliance with State and Federal HEDIS standards
Conduct telephonic outreach and health coaching to members
Provide face-to-face education to members and families about care gaps and barriers to care
Schedule doctor appointments and follow-up appointments for members
Arrange transportation and connect members with community-based resources and affinity programs
Act as liaison and member advocate between members/families, physicians, facilities, and agencies
Serve as the face of WellCare in embedded provider offices
Assess provider performance data and identify opportunities for improvement
Collaborate with Provider Relations on Quality, Risk Adjustment, Operations, claims, and encounters
Document all member-related contact actions
Interact with customer service and other departments to resolve member issues
Refer members to case or disease management as appropriate
Complete special assignments and other duties as assigned
Comply with all policies and standards

Requirements

What you’ll need

Must reside in the state of Michigan
Some travel required within and near Kalamazoo
Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related health field, or equivalent work experience
A total of 4 years of experience required for the position when using the equivalent work experience pathway
2+ years of work experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment
Preferred: Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Certified Social Worker (C-SW), Licensed Social Worker (LSW), or Licensed Registered Nurse (RN)
Driver's license required for Michigan plan
Ability to maintain confidentiality of business and protected health information
Knowledge of HEDIS measures and HEDIS ICD-10/CPT coding in accordance with NCQA requirements

Benefits

Comp & perks

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
Competitive pay
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity