Outreach Care Specialist

Elevance Health • Lafayette, LA

3d • Hybrid

About The Position

The Outreach Care Specialist will be responsible for ensuring that appropriate member treatment plans are followed on less 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.

Requirements

• 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.

Nice To Haves

• Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
• Certification as a Community Health Worker, preferred.
• Experience working in the community, preferred.
• Experience working with individuals and families dealing with chronic health conditions, behavioral health issues, and disabilities preferred.
• Proficient phone skills, preferred.
• Experienced and comfortable with taking directions, following processes, and coordinating care plan needs, preferred.
• Bilingual candidates preferred.
• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• For Carelon - CareBridge business unit, bilingual or multi-language skills may be required.

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.

Benefits

• 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: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees