Outreach Care Specialist Senior
Elevance Health

Job Info

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Outreach Care Specialist Senior

Location : This is a fully remote position. Ideal candidates will live within 50 miles of one of the following PulsePoint locations : Louisville, KY, Shelbyville, KY, Charleston, WV or Metairie, LA.

The Outreach Care Specialist Senior is responsible for ensuring that appropriate member treatment plans are followed on complex cases and for proactively identifying ways to improve the health of our members and meet quality goals.

How you will make an impact :

• 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 through on-site visits.
• Identifies barriers to plan compliance and coordinates resolutions.
• Identifies opportunities that impact quality goals and recommends process improvements.
• Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
• Coordinates identification of and referral to local, state or federally funded programs.
• Coaches members on ways to reduce health risks.
• Prepares reports to document case and compliance updates.
• Establishes and maintains relationships with agencies identified in appropriate contract.
• Provides education to members regarding all services available.
• Participates in cross-functional teams on projects, initiatives, and process improvement activities.

Minimum Requirements :

• Requires a H.S. diploma or equivalent and a minimum of 4 years related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences :

• Behavioral health experience.
• Experience locating community resources for members.
• Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
• Bilingual candidates preferred.

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