Community Health Navigator

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

Job summary

A leading healthcare organization is seeking passionate individuals to join their team as community outreach specialists. This role involves connecting with members, educating the community, and addressing healthcare needs. Candidates should have a background in healthcare or human services, with a preference for experience in pediatrics. The position requires effective communication, community engagement, and a commitment to diversity and inclusion.

Benefits

Health insurance from Day 1

401(k)

Tuition reimbursement

Paid time off

Holidays

Qualifications

• Minimum of 2 years of healthcare or human services experience.
• Experience with pediatric populations is highly preferred.

Responsibilities

• Establish connection and act as the primary contact to a targeted member population.
• Develop and maintain relationships with community organizations.

Skills

Communication

Community-based care

Health education

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 Pediatrics 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 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:

1. Member Outreach:

• Establish connection and act as the primary ACFC contact to a targeted member population, including some high-risk members, through home visits and outreach calls.
• Identify SDOH needs and address them appropriately, utilizing resources like NCCARE 360 and assessing eligibility for the Healthy Opportunities Pilot program (HOP).
• Exercise judgment in care coordination by handling follow-up tasks and collaborating with care management teams, community providers, and organizations.
• Inform members of required actions to fulfill HEDIS, EPSDT, and Plan requirements, encouraging compliance through calls or visits.
• Assist in addressing members’ barriers to care and foster relationships with medical/dental providers.

Community Education:

• Develop and maintain relationships with community organizations via phone, mail, email, or visits.
• Collaborate with internal and external entities to gather data pertinent to health education programs.
• Provide education to members about 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 pediatric populations is highly preferred.

Other Skills:

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

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means all associates have a fair opportunity to achieve their full potential. We act with integrity and respect, stand against injustice, and support a more inclusive workplace. We celebrate diverse perspectives to foster innovation and better serve communities.

Our Comprehensive Benefits Package

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