Remote Outreach & Care Coordination Specialist

Elevance Health, Inc.; United States; À distance; USD 42 000 - 54 000; Plein temps

Avantages offerts par ce poste

Virtual work option

In-person training sessions

Résumé du poste

Elevance Health seeks an Outreach Care Specialist I to ensure member treatment plans are followed on less complex cases and to proactively identify improvements to health outcomes and quality metrics.

You will initiate referrals, coordinate follow-up care, assess adherence, and collaborate with case management to optimize member health. A HS diploma with 1 year of related experience is required, with CNA/CMA or BS/BA preferred.

Qualifications

• Requires a HS diploma or equivalent and a minimum of 1 year related experience.
• Preferred CNA or CMA and/or BS/BA degree in a related field.
• Minimum 1-year referral management and/or care coordination is preferred.
• Bilingual candidates preferred.
• Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook).
• Experience with clinical systems (electronic medical record, care management or population health management).
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or detailed information clearly.

Responsabilités

• Initiates referrals to specialists, labs and imaging centers.
• Coordinates follow-up care by scheduling appointments or enrolling members.
• Assesses compliance via phone or on-site visits.
• Identifies barriers to plan compliance and coordinates resolutions.
• Identifies opportunities to impact quality goals and recommends process improvements.
• Supports medical record audits for HEDIS/Star goals.
• Recommends plan modifications with case management for additional services.
• Refers members to local/state/federal programs.
• Counsels members on reducing health risks.
• Prepares case/compliance reports.
• Participates in cross-functional teams on projects.
• Maintains relationships with contracting agencies.

Connaissances

Communication skills

Bilingual

Verbal communication

Formation

High School Diploma or equivalent

CNA or CMA preferred

BS/BA degree preferred

Outils

Microsoft Office

EMR systems

Description du poste

Elevance Health seeks an Outreach Care Specialist I to ensure member treatment plans are followed on less complex cases and to proactively identify improvements to health outcomes and quality metrics.

You will initiate referrals, coordinate follow-up care, assess adherence, and collaborate with case management to optimize member health. A HS diploma with 1 year of related experience is required, with CNA/CMA or BS/BA preferred.