Remote Care Coordination Specialist

Elevance Health (Anthem); Nashville (TN); Remote; USD 42,000 - 65,000; Full time

Job summary

Elevance Health is seeking an Outreach Care Specialist to support members in coordinating care and managing referrals. This remote role offers flexible hours with required in-person trainings and onboarding.

The position focuses on coordinating care plans, assessing adherence to treatment, and driving program access. Strong communication and multitasking skills are essential, with bilingual candidates preferred.

Qualifications

• Requires a H.S. diploma or equivalent and a minimum of 1 year related experience.
• BS/BA degree in a related field preferred.
• PTA/OTA with at least one year of experience preferred.
• Minimum 1 year of DME ordering experience preferred.
• Experience dealing with vendors and insurance companies preferred.
• Proficient in MS Office (Word, Excel, PowerPoint & Outlook).
• Minimum 2 years' experience with clinical systems (EMR, care management, or population health).
• Excellent verbal and written communication; able to convey complex information clearly.
• Bilingual candidates preferred.

Responsibilities

• Initiates and manages clinical referrals and orders including Specialists, Labs and Imaging Centers.
• Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
• Assesses member compliance with medical treatment plans via telephone or on-site visits.
• Identifies barriers to plan compliance and coordinates resolutions.
• Identifies opportunities to improve quality goals and suggests process improvements.
• Maintains medical record audit support to support HEDIS/Star goals.
• Recommends treatment plan modifications with case management and provider.
• Coordinates referral to local/state/federal funded programs.
• Coaches members on reducing health risks.
• Prepares reports documenting case and compliance updates.

Skills

Verbal communication

Written communication

Multitasking

Vendor management

Microsoft Office

Clinical systems experience

Education

HS diploma

BS/BA degree in related field

PTA/OTA certification

Tools

Microsoft Office

EMR systems

Care management software

Job description

Elevance Health is seeking an Outreach Care Specialist to support members in coordinating care and managing referrals. This remote role offers flexible hours with required in-person trainings and onboarding.

The position focuses on coordinating care plans, assessing adherence to treatment, and driving program access. Strong communication and multitasking skills are essential, with bilingual candidates preferred.