You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Must reside in Nevada for facility visits.

Position Purpose: Facilitate a smooth transition from the acute care setting to the next level of care for high-risk members identified for complex discharge planning. Assess and continuously evaluate level of care needs, unmet psychosocial needs and supportive service needs to collaborate on the development of a safe transition plan that supports members. Engage hospital providers and staff, community agencies and other identified stakeholders to coordinate a safe, effective and clinically appropriate transition plan.

• Assess, plan and coordinate safe, effective and clinically appropriate transition plans.

• Collaborate with internal and external teams for clinical case review and planning.

• Facilitate accurate and timely documentation.

• Establish and maintain collaborative relationship with hospitals and other identified stakeholders.

• Identify and establish a plan to address barriers in order to reduce length of stay and reduce readmissions.

• Focus on members’ needs across the care continuum.

• Provide daily team support to ensure member needs are addressed.

• May become subject matter expert for teammates and stakeholder questions.

• Support continuous quality improvement by participating in process improvement, development of new processes or policies, and identifying opportunities for improvement.
• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Bachelor’s or graduate degree from an accredited school of nursing or graduate degree from an accredited school of social work. 4+ years of nursing or social work experience. 1+ years of care coordination or discharge/transition planning. Public health, home health, or acute care transition knowledge preferred. Familiar with utilization management protocols, trauma informed care and social determinants of health. Knowledge of behavioral health impacts on physical health and the reverse. Demonstrated the ability to lead project implementation and initiative in taking on additional responsibilities.

License/Certification: Current state's RN license or LICSW required.

For NEVADA-SILVERSUMMIT HEALTH PLAN:
Social worker license types may include:
LMSW: Licensed Master Social Worker

LISW: Licensed Independent Social Worker

LCSW: Licensed Clinical Social Worker

LCW: Licensed Social Worker

Pay Range: $33.03 - $59.47 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act