Outreach Care Specialist Lead - Carelon

Elevance Health • Lakewood, WA

3d • $31 - $47 • Hybrid

About The Position

The Outreach Care Specialist Lead - Carelon is responsible for ensuring that appropriate member treatment plans are followed on the most 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. Serves as a team lead. Participates in cross-functional teams on projects, initiatives, and process improvement activities.

Requirements

• Requires a H.S. diploma or equivalent and 5 years of related experience; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

• Behavioral/Mental Health experience.
• Certified nurse assistant or certified medical assistant.
• Bilingual.
• Master’s degree in social work, behavioral health, or closely related field.
• 3+ years of project/program management experience, preferably in behavioral health, child/youth services, healthcare, or cross-system care coordination.
• Experience working in a lead role on one or more projects.
• Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Responsibilities

• 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.
• Serves as a team lead.
• Participates in cross-functional teams on projects, initiatives, and process improvement activities.

Benefits

• In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED