Community Representative Job at Sunshine State Health Plan, Florida

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Job Description

You could be the one who changes everything for our 26 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.

Position Purpose: Responsible for delivering of a range of activities for individuals who are enrolled in the health plan for Medicaid or and Medicare in order to impact individual health outcomes and provide assistance to the clinical team of nurses and social workers. Activities include, but are not limited to outreach, community education, informal guidance and member support. Must reside in Miami Dade County for field visits to members.

Educate, coach and support members to understand disease prevention and achieve good health outcomes, including diabetes, high blood pressure, mental health, substance use, etc.
Participate in coordination and resolution of medical and non-medical needs, including appointment tracking, documentation of member information, referrals and follow up, facilitating transportation to services, etc.
Participate in meetings with external providers and community organizations to build partnerships for our members to be able to leverage member care services. Provide key information to providers for improving members care based on member’s home environment and communities.
Conduct non-clinical general health assessments in order to refer members to appropriate services, resolve concerns on member’s behalf, and gather information for medical providers and staff working within the organization.
Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate services, resolve concerns on member’s behalf, and gather information for medical providers in staff working within our organization.
Coordinate and implement community events such as baby showers, health fairs, and other health education events.
Conduct telephonic and in-person outreach to locate individuals and families in the community who are hard to reach.
Work with other community health workers internally and externally to share best practices, strengthen education and outreach.
Participate in large scale community assessments including resource mapping, community surveys, and community meetings to discuss findings and resolutions to key member concerns.
Make frequent visits to individual homes and community organizations.
Must reside in Miami Dade County for field visits to members.

Education/Experience: High school diploma or equivalent. 2+ years of community health, social work, social services, community advocacy, community outreach, member services, or education, experience. Understanding of the community in designated region through shared experiences or strong desire to help people in vulnerable communities. Bilingual skills preferred.

Licenses/Certifications: Valid driver’s license and proof of insurance. Community Health Worker Training/Certification must be successfully completed within 15 weeks of hire date.

For Sunshine LOB: Community Health Worker Training/Certification preferred, but not required.

Must reside in Miami Dade County for field visits to members.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

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