Community Health Navigator

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

Job summary

A leading health care organization is seeking passionate individuals to join their team. This remote role focuses on member outreach and community education, requiring strong communication skills and a background in healthcare. The ideal candidate will have experience with high-risk populations and be committed to fostering healthier communities.

Benefits

Competitive pay

Paid time off

Health insurance from Day 1

401(k)

Tuition reimbursement

Qualifications

• Minimum of 2 years of healthcare or human services experience.
• Experience with HCHU population highly preferred.

Responsibilities

• Establishes connection with targeted member population through outreach.
• Develops relationships with community organizations for health education.
• Informs members of required actions to fulfill health plan requirements.

Skills

Community-based care experience

Communication

Medical terminology

Education

Associate’s Degree in Healthcare

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 national footprint 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. Our offerings include 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 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, 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 calls or visits, and encourages compliance.
• Assists in addressing members’ barriers to care and fosters relationships with their medical/dental providers.

Community Education:

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

Education/Experience:

• Associate’s Degree in Healthcare, Human Services, or related field or equivalent work experience required.
• Bachelor’s Degree preferred.
• Minimum of 2 years of healthcare or human services experience.
• Experience with HCHU population highly preferred.

Other Skills:

• Community-based care experience preferred.
• Experience presenting health education materials to individuals and groups.
• Knowledge of medical terminology and disease processes.
• Ability to communicate health management philosophies effectively.
• Knowledge of Medicaid requirements and managed care.
• Travel will constitute approximately 50% of the time.

Diversity, Equity, and Inclusion

We are committed to creating an inclusive environment where everyone feels valued and supported. Our principles of equity guide us to act with integrity and respect, fostering a workplace that embraces diverse perspectives and experiences.

Our Benefits:

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