Community Health Navigator

AmeriHealth Caritas; High Point (NC); Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking passionate healthcare leaders to join their remote team. This role focuses on member outreach and community education, requiring strong communication skills and a commitment to health equity. You'll connect with high-risk members, addressing social determinants of health and fostering relationships with community organizations. With a comprehensive benefits package and a mission-driven culture, this opportunity allows you to make a meaningful impact in the lives of many while enjoying a supportive work environment.

Benefits

Competitive pay

Paid time off

Health insurance coverage from Day 1

401(k)

Tuition reimbursement

Qualifications

• 2+ years of healthcare experience in an office or clinic setting.
• Associate’s Degree required; Bachelor's preferred.

Responsibilities

• Conduct outreach to members, addressing their health needs.
• Develop relationships with community organizations for education.
• Collaborate with care management teams for effective support.

Skills

Community-based care experience

Health education presentation

Knowledge of medical terminology

Communication skills

Medicaid knowledge

Managed care knowledge

Education

Associate’s Degree in Health Care

Bachelor’s Degree

Job description

This role is remote; however, candidates MUST live in or very near Raleigh, NC. Experience in HCHU is highly preferred.

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 one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions through our 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:

1. 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 care coordination by handling basic follow-up tasks and collaborating with care management teams, community-based providers, and other organizations.
• Informs members of required actions to fulfill HEDIS, EPSDT, and Plan requirements through phone calls or home visits, encouraging compliance.
• Assists in addressing members’ barriers to care and fosters relationships with their medical/dental providers (medical/dental homes).

Community Education:

• Develops and maintains relationships with community organizations via phone, mail, email, or personal visits.
• Collaborates with internal departments and external agencies to obtain data relevant to health education and promotion programs.
• Provides education to members and 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 years of healthcare experience in an office, clinic, hospital, or human services setting.
• Experience with HCHU population highly preferred.

Other Skills:

• Community-based care experience preferred.
• Experience presenting health education to individuals and small groups.
• Knowledge of medical terminology and disease processes.
• Ability to communicate preventive health and management philosophies effectively.
• Comprehensive knowledge of Medicaid requirements, 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 being themselves. Our commitment to equity means all associates have fair opportunities to reach their potential. We act with integrity and respect daily, speak out against injustice, and work to break down barriers for a more inclusive and equitable workplace. Celebrating diverse thoughts and perspectives makes us more vibrant, innovative, and better equipped to serve our communities.

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

Our Comprehensive Benefits Package

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