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Patient Care Advocate
Centene Corporation. Work with members and providers to close care gaps and remove barriers to care .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care gap closure, member advocacy, and quality improvement within healthcare settings. Proficient in HEDIS measures, patient education, and collaboration with providers to enhance member experiences.
Highest-signal resume keywords
HEDIS MeasuresQuality ImprovementDirect Patient CareHealth CoachingManaged Care Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care Gap ClosureProvider EducationCompliance StandardsData AssessmentDocumentation
Soft Skills
CommunicationCollaborationAdvocacyProblem-Solving
Tools & Technologies
Telephonic OutreachCommunity Resources Coordination
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
HealthcarePublic HealthSocial WorkHealth AdministrationManaged Care
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 and educate them on HEDIS measures and 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 embedded in provider offices
- Educate members and families about identified care gaps and barriers to care
- Schedule doctor appointments and coordinate transportation, follow-up appointments, community resources, and affinity programs
- Act as liaison and member advocate between members/families, physicians, facilities, and agencies
- Serve as Centene/WellCare representative in provider communities
- Assess provider performance data and identify improvement opportunities
- 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- Remote opportunity for Iowa residents
- 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 equivalent work experience
- 2+ years of experience in direct patient care, social work, quality improvement, or health coaching
- Experience preferably in a managed care environment
- One of the following preferred: Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Certified Social Worker (C-SW), Licensed Social Worker (LSW), or Licensed Registered Nurse (RN)
- Must maintain confidentiality of business and protected health information
- For Michigan plan only: Driver's license required
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