Palliative Care/Hospice Clinical Specialist

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 have a CA RN license or willing to obtain. Will need to work Monday - Friday 8am - 5pm PST.

Position Purpose:
The Palliative Care/Hospice Clinical Specialist is responsible providing Palliative Care (PC)/Hospice program support and for the coordination of care for members enrolled in Palliative Care/Hospice. This role involves engaging with members, their families, caregivers, PC/Hospice vendors, and health care providers to ensure optimal care and support. The coordinator will act as a subject matter expert in Palliative Care/Hospice, facilitating advanced care planning discussions, and ensuring smooth transitions between care settings.

• Coordination of care for Palliative Care/Hospice members

• Engage with members, family members and/or caregivers as appropriate

• Engage with providers regarding program benefits and communicate member needs

• Participate in UM and CM clinical rounds to identify potential members

• Collaborate with internal and external partners (hospitals, vendors, physician groups, internal departments (CM, UM, Analytics, etc.)

• Education about Palliative Care/Hospice, symptom management, disease process, guidelines and act as a Palliative/Hospice Care Subject Matter Expert (SME)

• Facilitate advanced care planning discussion with members, families and/or caregivers.

• Assist in processing palliative care/hospice care referrals

• Maintain internal program tracker and regulatory requirement responsibilities

• Assist in preparation for and attend JOMs – monthly or quarterly as scheduled

• Ensure appropriate care transitions from different settings (acute vs. Skilled Nursing Facility (SNF)) or from different programs (Palliative Care or Hospice).

• Monitor Palliative Care/Hospice vendor performance and escalate red flag issues

• Reconcile Palliative Care/Hospice invoices to be processed for payment

• Document all interactions in the electronic health record system.

• Stay updated with the latest Palliative Care/Hospice practices and guidelines through continuous education and training.
• Performs other duties as assigned.

• Complies with all policies and standards.

Education/Experience:
Current state RN Licensure required. 2+ years in Palliative and Hospice required.
Associate's Degree Nursing required

2+ years Palliative Care and Hospice required

Licenses/Certifications:
CA RN License required

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, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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