Remote Outreach & Care Coordination Specialist

Elevance Health, Inc.; Oregon; Hybrid; USD 45,000 - 65,000; Full time

Job summary

Elevance Health, Inc. is seeking an Outreach Care Specialist to support member treatment plans and coordinate care across clinicians, labs, and imaging centers. The role emphasizes proactive health management, compliance, and program improvement.

The position offers flexible virtual work within CST/EST time zones, with in-person training as required, and a focus on quality outcomes, member advocacy, and cross-functional collaboration.

Qualifications

• Requires a H.S. diploma or equivalent and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.
• 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.

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 that impact quality goals and recommends process improvements.
• Medical record audit support to support HEDIS/Star program goals.
• Recommends treatment plan modifications and determines need for additional services with case management and provider.
• Coaches members on ways to reduce health risks.
• Prepares reports to document case and compliance updates.
• Participates in cross-functional teams on projects and process improvement.

Skills

Verbal and written communication

Multitasking

Vendors and insurance coordination

Bilingual (preferred)

Education

HS diploma or equivalent

BS/BA degree preferred

PTA/OTA credential (preferred)

DME ordering experience (preferred)

Tools

Microsoft Office

Job description

Elevance Health, Inc. is seeking an Outreach Care Specialist to support member treatment plans and coordinate care across clinicians, labs, and imaging centers. The role emphasizes proactive health management, compliance, and program improvement.

The position offers flexible virtual work within CST/EST time zones, with in-person training as required, and a focus on quality outcomes, member advocacy, and cross-functional collaboration.