Community Health Navigator - LTSS | Remote in Raleigh, NC

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

Job summary

Join a mission-driven organization dedicated to improving health care access and outcomes for communities. This role involves outreach to members, coordinating care, and educating individuals about health benefits. You will work closely with various health care providers and community organizations to ensure members receive the necessary support and resources. Ideal candidates will have a background in health care or human services, strong communication skills, and a passion for making a difference. Embrace the opportunity to contribute to healthier communities while enjoying a comprehensive benefits package and a supportive work environment.

Benefits

Competitive Pay

Paid Time Off

Health Insurance on Day 1

401(k)

Tuition Reimbursement

Qualifications

• Minimum 2 years of health care or human services experience required.
• Associate’s Degree in Health Care or related field is mandatory.

Responsibilities

• Assist LTSS members with scheduling in-home assessments and coordinate care.
• Develop relationships with community organizations and provide health education.

Skills

Effective Communication

Community Outreach

Health Education Presentation

Problem Solving

Education

Associate’s Degree in Health Care

Bachelor’s Degree

Tools

Microsoft Office Suite

Database Management Systems

Job description

This role is remote; however, candidates must reside within an hour radius of Raleigh, 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 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, specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Member Outreach:

1. Assists the LTSS member population with scheduling of in-home PCS assessments.
2. Collaborates with Personal Care Agencies, Home Health Agencies, and physicians' offices to coordinate the LTSS member needs.
3. 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.
4. 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.
5. 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.
6. Assists in addressing members’ barriers to care and encourages/fosters relationships with their medical/dental providers (medical/dental homes).

Community Education:

1. Develops and maintains relationships with new and established community organizations via phone, mail, e-mail, or personal visits.
2. Collaborates with internal departments and external agencies to obtain data that is pertinent to the overall success of health education/promotion programs.
3. Provides education to members and member representatives regarding available benefits.

Education/Experience:

1. Associate’s Degree in Health Care, Human Services, or a related field or equivalent work experience required.
2. Bachelor’s Degree preferred.
3. Minimum of 2 (two) years of health care in an office/clinic/hospital setting or human services experience.
4. Experience with LTSS population highly preferred.

Other Skills:

1. Comprehensive knowledge of Microsoft Office Suite and all of its functionality (Word, Excel, Teams, PowerPoint, Outlook).
2. Thorough understanding of database management and documentation systems.
3. Community-based care experience preferred.
4. Previous experience in presenting health education materials to individuals and small groups.
5. Knowledge and understanding of medical terminology, disease processes, and behavioral health conditions.
6. Ability to effectively communicate preventive health and health management philosophies to members and agencies.
7. Comprehensive knowledge of Medicaid requirements and plan, policies, and procedures.
8. Knowledge of managed care.
9. 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.