Quality Care Advocate

Centene Corporation

. Conduct outreach to members in the community to identify care gaps and connect them with appropriate healthcare services and resources .

Posted 10/8/2026full-timeSan Diego • California • United StatesJuniorMid-Level💰 $27 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in community health outreach, care coordination, and navigating healthcare systems, with a strong focus on member engagement and compliance with regulations. Proficient in utilizing quality performance data to enhance care delivery and improve health outcomes.

Highest-signal resume keywords

Community Health OutreachCare CoordinationHEDIS FamiliarityMedicaid / Medicare KnowledgeLicensed Clinical Social Worker (LCSW)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Community-Based AssessmentsPreventive Care EducationCare Gap IdentificationAppointment SchedulingQuality Performance Data Analysis

Soft Skills

Strong Communication SkillsInterpersonal SkillsFlexibilityRelationship Building

Tools & Technologies

Care Management SystemsQuality Metrics Reporting Tools

Certifications & Qualifications

Licensed Clinical Social Worker (LCSW)Registered Nurse (RN) State Licensure

Industry Keywords

Social Determinants of HealthHealthcare ServicesCommunity ResourcesCompliance with RegulationsHealth Plan Members

About the role

Key responsibilities & impact

Conduct outreach to members in the community to identify care gaps and connect them with appropriate healthcare services and resources
Perform home visits or community-based assessments to evaluate member needs and identify social determinants of health
Facilitate care coordination and help members access preventive or follow-up care
Help members navigate healthcare and social service systems
Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements
Collaborate with providers using quality performance data such as HEDIS and CAHPS
Educate members on preventive care, chronic condition management, and community resources
Document member interactions, care gap closures, and referrals in appropriate systems
Partner with Quality, Care Management, and Provider Relations departments
Monitor and report outreach effectiveness and care gap closure metrics
Maintain compliance with state and federal regulations and organizational policies
Participate in seasonal campaigns and quality initiatives
Build relationships with local organizations and stakeholders as a community ambassador
Perform other duties as assigned
Comply with all policies and standards

Requirements

What you’ll need

Bachelor's Degree in Social Work, Public Health, Nursing, or related field; or equivalent experience required
2+ years in community health or healthcare quality required
Experience working with health plan members and navigating community resources required
Familiarity with Medicaid / Medicare programs and quality measures (e.g., HEDIS) required
Strong communication and interpersonal skills
Candidates must be based in San Diego
Flexibility to meet members’ needs, accommodate visit schedules, and ensure high-quality service delivery
LCSW (Licensed Clinical Social Worker) preferred
RN (Registered Nurse) state licensure and/or compact state licensure preferred

Benefits

Comp & perks

Mileage reimbursement for travel in the community for member visits
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
Additional forms of incentives may be included in total compensation
Equal opportunity and diversity commitment