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Outreach Care Specialist I/II - Remote - Must live in an Anthem state and must live within 50 mil...

Anthem Apple Valley, CA
  • Posted: August 11, 2019
  • Full-Time

Outreach Care Specialist I/II - Remote - Must live in an Anthem state and must live within 50 miles of an Anthem office - PS25673
Location: United States
New
Requisition #: PS25673
Post Date: 9 hours ago
Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.
This position will be Remote - You must live in an Anthem state and must live within 50 miles of an Anthem office. Availability needed M-F 8:00am-8:00pm Eastern Time Zone, for an 8 hour shift. Must be able to work a day or evening shift.
Outreach Care Specialist I/II
Manager will determine level based upon the selected applicant's skill-set relative to the qualifications listed for this position.
Outreach Care Specialist I
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.
Primary duties may include, but are not limited to:

  • 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.
Outreach Care Specialist II
Responsible for ensuring that appropriate member treatment plans are followed on moderately complex cases and for proactively identifying ways to improve the health of our members and meet quality goals.
Primary duties may include, but are not limited to:
  • 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 preceptor for new associates and participates in or leads projects with cross-functional teams.
Qualifications
Outreach Care Specialist I
  • Requires a high school diploma or GED;
  • 1 year of related experience;
  • Or any combination of education and experience, which would provide an equivalent background.
  • Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
  • For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Outreach Care Specialist II
  • Requires a high school diploma or GED;
  • 3 years of related experience;
  • Or any combination of education and experience, which would provide an equivalent background.
  • Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
Preferred Qualifications
  • 1-3 years of experience Healthcare customer service
  • Medical terminology.
  • Strong computer skills.
  • Tech savvy i.e. reading spreadsheets and data.
  • Microsoft Office experience.
  • Working knowledge using CARE COMPASS; Facets, Member 360.
  • Strong oral and written communication.
  • Case management experience.
  • Motivational interviewing experience.
  • Discharge planning experience.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

Anthem

Address

Apple Valley, CA
92307 USA

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