Community Health Navigator

AmeriHealth Caritas; Clinton (NC); Remote; USD 40,000 - 55,000; Full time

Job summary

A leading health care organization is seeking a compassionate individual for a remote position focused on member outreach and community education. The role involves establishing connections with members, providing education about available benefits, and addressing barriers to care, requiring strong communication and healthcare experience.

Benefits

Competitive pay

Health insurance from Day 1

401(k) plan

Tuition reimbursement

Paid time off including holidays

Qualifications

• 2 years healthcare experience in an office/clinic/hospital setting.
• Ability to effectively communicate and present health education materials.
• Knowledge of managed care and this community.

Responsibilities

• Connect with members through home visits and outreach calls.
• Develop relationships with community organizations.
• Educate members regarding available health benefits.

Skills

Community based care experience

Health education communication

Knowledge of Medicaid requirements

Understanding of medical terminology

Education

Associate’s Degree in Health Care, Human Services

Bachelor’s Degree preferred

Job description

This role is remote however candidates MUST live in or very near Clinton, NC.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com .

Responsibilities:

Member Outreach:

• Establishes connection and acts as the primary ACFC contact to a targeted member population, including some high-risk members, through home visits and outreach calls.
• Identifies SDOH needs and addresses them appropriately, effectively, and efficiently utilizing all available resources including NCCARE 360 and assessing eligibility for the state’s Healthy Opportunities Pilot program (HOP).
• Exercises judgment and discretion in the coordination of care by handling basic care follow up tasks and collaborating with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations.
• Informs members of the required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach, through phone calls or home visits, and encourages them to comply.
• Assists in addressing members’ barriers to care and to encourage/foster relationships with their medical/dental providers (medical/dental homes).

Community Education:

• Develops and maintains relationships with new and established community organizations via phone, mail, e-mail, or personal visits.
• Collaborates with internal departments and external agencies to obtain data that is pertinent to the overall success of health education/promotion programs.
• Provides education to members and member representatives regarding available benefits.

Education/Experience:

• Associate’s Degree in Health Care, Human Services, or a related field or equivalent work experience required
• Bachelor’s Degree preferred

• Minimum of 2 (two) years of health care in an office/clinic/hospital setting or human services experience

Other Skills:

• Community based care experience preferred
• Previous experience in presenting health education materials to individuals and small groups
• Knowledge and understanding of medical terminology and disease processes
• Ability to effectively communicate preventive health and health management philosophies to member’s and agencies
• Comprehensive knowledge of Medicaid requirements and plan, policies and procedures
• Knowledge of managed care
• 50% of time will be spent traveling

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more.