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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.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in community health outreach, care coordination, and navigating healthcare systems, with a strong focus on member education and quality improvement initiatives. Proficient in assessing social determinants of health and utilizing quality measures such as HEDIS to enhance care delivery.
Highest-signal resume keywords
Community Health OutreachCare CoordinationHEDIS FamiliarityMedicaid / Medicare KnowledgeInterpersonal Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Community-Based AssessmentsCare Gap IdentificationAppointment SchedulingQuality Performance Data SharingDocumentation of Member Interactions
Soft Skills
Strong Communication SkillsInterpersonal SkillsFlexibility
Certifications & Qualifications
LCSW LicenseRN State Licensure
Industry Keywords
Social Determinants of HealthHealthcare ServicesQuality Improvement InitiativesPreventive Care EducationCompliance with Regulations
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 navigate healthcare and social service systems.
- Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements.
- Collaborate with providers by sharing quality performance data, including HEDIS and CAHPS, and supporting improvement initiatives.
- 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, Provider Relations, and other internal departments.
- Monitor and report on outreach effectiveness and care gap closure metrics.
- Participate in seasonal campaigns and quality initiatives.
- Serve as a community ambassador and build relationships with local organizations and stakeholders.
- Perform other duties as assigned and comply with organizational policies and standards.
Requirements
What you’ll need- Bachelor's Degree 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
- LCSW license preferred
- RN state licensure and/or compact state licensure preferred
- Candidates must be based in Androscoggin County
- Flexibility to accommodate visit schedules and members' needs
- Compliance with state and federal regulations and organizational policies
Benefits
Comp & perks- Mileage reimbursement is provided for travel in the community for member visits.
- Health insurance
- 401K and 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
- Comprehensive benefits package, subject to program eligibility