Community Health Navigator

AmeriHealth Caritas; Durham (NC); Remote; USD 45,000 - 60,000; Full time

Job summary

A leading health care organization is seeking passionate individuals to join their team as they work to improve community health. The role involves member outreach, community education, and collaboration with care management teams. Ideal candidates will have experience in healthcare settings and a commitment to diversity and inclusion.

Benefits

Competitive pay

Paid time off including holidays

Health insurance coverage from Day 1

401(k)

Tuition reimbursement

Qualifications

• Minimum of 2 years of experience in healthcare settings or human services.

Responsibilities

• Establishes connection and acts as the primary contact for targeted members.
• Develops and maintains relationships with community organizations.
• Provides education to members about available benefits.

Skills

Communication

Community-based care experience

Knowledge of medical terminology

Education

Associate’s Degree in Health Care

Bachelor’s Degree

Job description

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

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As a national leader in health care solutions, we offer our associates the opportunity to impact the lives of millions through our wide range of products, services, and award-winning programs. We are 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 over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most, including integrated managed care products, pharmaceutical benefit management, 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 contact for targeted members, including some high-risk individuals, through home visits and outreach calls.
• Identifies social determinants of health (SDOH) needs and addresses them using available resources like NCCARE 360 and assesses eligibility for the Healthy Opportunities Pilot program (HOP).
• Exercises judgment and discretion in care coordination by handling follow-up tasks and collaborating with care management teams, community providers, and other organizations.
• Informs members of required actions to meet HEDIS, EPSDT, and plan requirements through calls or visits, encouraging compliance.
• Assists in overcoming barriers to care and fosters relationships with members’ medical and dental providers.

Community Education:

• Develops and maintains relationships with community organizations via phone, mail, email, or visits.
• Collaborates internally and externally to gather data relevant to health education and promotion programs.
• Provides education to members and representatives about available benefits.

Education/Experience:

• Associate’s Degree in Health Care, Human Services, or related field, or equivalent work experience required.
• Bachelor’s Degree preferred.
• Minimum of 2 years of experience in healthcare settings or human services.

Other Skills:

• Community-based care experience preferred.
• Experience presenting health education to individuals and groups.
• Knowledge of medical terminology and disease processes.
• Ability to communicate health management philosophies effectively.
• Understanding of Medicaid requirements, policies, and managed care.
• Approximately 50% travel required.

Diversity, Equity, and Inclusion

We are committed to creating a supportive, equitable workplace where everyone can be valued and respected. Our principles guide us in acting with integrity, embracing diversity, and breaking down barriers to foster an inclusive environment.

Our Benefits:

Competitive pay, paid time off including holidays and volunteer events, health insurance coverage from Day 1, 401(k), tuition reimbursement, and more.