Community Health Navigator

AmeriHealth Caritas; Winston-Salem (NC); Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking passionate individuals to join their team and make a difference in health care. This remote role focuses on member outreach and community education, ensuring that individuals receive the care they need. Ideal candidates will have experience in health care, particularly with pediatric populations, and possess strong communication skills. With a commitment to diversity and inclusion, this organization values every associate and offers a comprehensive benefits package from day one. If you're ready to impact lives and build healthier communities, this opportunity is for you.

Benefits

Competitive pay

Paid time off

Health insurance from Day 1

401(k)

Tuition reimbursement

Qualifications

• 2+ years of healthcare experience in an office/clinic/hospital setting.
• Experience with pediatric populations is highly preferred.

Responsibilities

• Establish connections with targeted member populations through outreach calls.
• Develop relationships with community organizations for health education.

Skills

Community-based care experience

Health education presentation

Medical terminology knowledge

Preventive health communication

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 Winston Salem, 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:

• 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).

1. 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.
• Experience with pediatric population highly preferred.

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 members and agencies.
• 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 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.