Community Health Navigator

Amerihealth Caritas•Washington, DC

10d•$64,300 - $87,700•Hybrid

About The Position

This is a hybrid position working in our DC office located at 1201 Maine SW. 4 days in office / 1 day remote. Responsibilities will include moderate or low risk member caseload. As well as the following: Member Outreach: 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. Identifies SDOH needs and addresses them appropriately. Exercises judgment and discretion in coordinating care by handling basic care follow-up tasks and collaborating with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations. 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. Assists in addressing members’ barriers to care and encourages/fosters relationships with their medical/dental providers (medical/dental homes). Community Education: Develops and maintains relationships with new and established community organizations via phone, mail, e-mail, or personal visits. Collaborates with internal departments and external agencies to obtain data that is pertinent to the overall success of health education/promotion programs. Provides education to members and member representatives regarding available benefits. Your career starts now. We’re looking for the next generation of healthcare 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 healthcare 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 and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us atwww.amerihealthcaritas.com.

Requirements

Associate’s Degree in Health Care, Human Services, or a related field or equivalent work experience required.
Minimum of 1 (one) year of health care in an office/clinic/hospital setting or human services experience.
Knowledge and understanding of medical terminology and disease processes.
Ability to effectively communicate preventive health and health management philosophies to members and agencies.
Comprehensive knowledge of Medicaid requirements and plan, policies, and procedures.
Knowledge of managed care.

Nice To Haves

Community-based care experience preferred.

Responsibilities

Manage a moderate or low risk member caseload.
Establish connection and act as the primary ACFC contact to a targeted member population, including some high-risk members, through home visits and outreach calls.
Identify SDOH needs and address them appropriately.
Coordinate care by handling basic care follow-up tasks and collaborating with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations.
Inform members of required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach through phone calls or home visits and encourage compliance.
Assist in addressing members’ barriers to care and encourage/foster relationships with their medical/dental providers (medical/dental homes).
Develop and maintain relationships with new and established community organizations via phone, mail, e-mail, or personal visits.
Collaborate with internal departments and external agencies to obtain data pertinent to the success of health education/promotion programs.
Provide education to members and member representatives regarding available benefits.