Quality Care Member Advocate

Centene Corporation

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

Posted 10/12/2026full-timeChicago • Illinois • 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 quality performance metrics. Proficient in assessing social determinants of health and maintaining compliance with healthcare regulations.

Highest-signal resume keywords

Community Health OutreachCare CoordinationHEDIS FamiliarityMedicaid / Medicare KnowledgeLCSW License

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Community-Based AssessmentsCare Gap IdentificationAppointment SchedulingPreventive Care EducationQuality Performance Data Analysis

Soft Skills

Strong Communication SkillsInterpersonal SkillsRelationship Building

Certifications & Qualifications

LCSW LicenseRN State Licensure

Industry Keywords

Social Determinants of HealthHealthcare ServicesCare PlansQuality InitiativesCompliance with Regulations

About the role

Key responsibilities & impact

Conduct outreach to members in the community to identify care gaps and connect them with 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 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
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
Must reside near Cook County, Illinois for member home visits
Travel up to 50%
LCSW license preferred
RN state licensure and/or compact state licensure preferred

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