15h Left: Senior Care Navigator
Company: Sunshine State Health Plan
Location: Miami
Posted on: July 10, 2025
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Job Description:
You could be the one who changes everything for our 28 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you’ll
have access to competitive benefits including a fresh perspective
on workplace flexibility. Position Purpose: Assesses, plans,
implements, and coordinates care management activities based on
member needs to provide quality, cost-effective healthcare
outcomes. Develops or contributes to the development of a
personalized care plan/service plan for members and educates
members and their families/caregivers on services and benefit
options available to improve health care access and receive
appropriate high-quality care through advocacy and care
coordination. - Develops or contributes to the development of
ongoing care plans/service plans and works to identify providers,
specialists, and/or community resources needed for care. -
Coordinates and manages as appropriate between the member and/or
family/caregivers and the care provider team to ensure identified
services are accessible to members in a timely manner. - May
monitor progress towards care plans/service plans goals and/or
member status or change in condition, and collaborates with
healthcare providers for care plan/service plan revision or address
identified member needs, refer to care management for further
evaluation as appropriate. - Provides psychosocial and resource
support to members/caregivers, and care managers to access local
resources or services such as: employment, education, housing,
food, participant direction, independent living, justice, foster
care) based on service assessment and plans. - Identifies
problems/barriers for care coordination and appropriate care
management interventions for members with higher level of care
needs. - Reviews referrals information and intake assessments to
develop or assist in the development of appropriate care
plan/service plan for members with higher level of care needs. -
Collaborates with healthcare partners as appropriate to facilitate
member care to ensure member needs are met and determine if care
plan/service plan revision is needed. - Collects, documents, and
maintains all member information and care management activities to
ensure compliance with current state, federal, and third-party
payer regulators. - May perform on-site visits to assess member’s
needs and collaborate with providers or resources, as appropriate.
- May provide education to care managers and/or members and their
families/caregivers on procedures, healthcare provider
instructions, care options, referrals, and healthcare benefits. -
Serves as a Subject Matter Expert (SME) to support the care
navigation team and/or serve as a preceptor for newly hired staff.
- Other duties or responsibilities as assigned by people leader to
meet the member and/or business needs. - Performs other duties as
assigned. - Complies with all policies and standards.
Education/Experience: Requires a Bachelor’s degree and 4 – 6 years
of related experience. Requirement is Graduate from an Accredited
School of Nursing if holding clinical licensure. Or equivalent
experience acquired through accomplishments of applicable
knowledge, duties, scope and skill reflective of the level of this
position. License/Certification: - Current state’s clinical license
preferred - For CMS Florida licensed practical nurse with a minimum
of four years of pediatric experience, or a Master’s degree in
social work with a minimum of one year of related professional
pediatric care experience. May require up to 80% local travel
required Pay Range: $26.50 - $47.59 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, 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
Keywords: Sunshine State Health Plan, Miami Beach , 15h Left: Senior Care Navigator, Healthcare , Miami, Florida