Quality Care Member Advocate

• Conduct outreach to members in the community to identify care gaps and connect them with appropriate healthcare services and resources.
• Perform home visits or community-based assessments to evaluate member needs and identify social determinants of health that may prevent members from accessing preventive or follow-up care and facilitate care coordination.
• Serve as a member advocate by helping individuals navigate complex healthcare and social service systems. Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements, ensuring members receive the support needed to close care gaps and maintain continuity of care
• Collaborate with providers to share quality performance data (e.g., HEDIS, CAHPS) and support improvement initiatives.
• Educate members on preventive care, chronic condition management, and available community resources.
• Document member interactions, care gap closures, and referrals in the appropriate systems.
• Partner with internal departments (e.g., Quality, Care Management, Provider Relations) to align efforts and improve member outcomes.
• Monitor and report on outreach effectiveness and care gap closure metrics.
• Maintain compliance with state and federal regulations and organizational policies.
• Participate in seasonal campaigns and quality initiatives to improve member engagement and health outcomes.
• Serve as a community ambassador, building relationships with local organizations and stakeholders.
• Performs other duties as assigned.
• Comply with all policies and standards
• Travel is required for member visits

• 3+ years of direct experience in care coordination, care management, community/public health education, HEDIS, quality measures, or health screening assessments.
• 3+ years of experience supporting preventive care outreach and helping members navigate community resources.
• Experience supporting members with physical health conditions, preventive care needs, and chronic disease management, such as diabetes, hypertension, high cholesterol, or stress-related conditions.
• Knowledge of Medicaid/Medicare programs and quality measures, including HEDIS.
• Field-based experience strongly preferred; bilingual English/Spanish skills are a plus but not required.
• Strong clinical documentation, problem-solving, communication, attention to detail, organization, and time management skills required.
• Ability to adapt to changing business needs with openness, flexibility, and professionalism.
• Comfortable presenting findings clearly and concisely to various stakeholders.

• RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred, but not required

• LCSW - License Clinical Social Worker preferred, but not required

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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