Your Talent. Our Vision. At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, it's a powerful combination and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, 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.
Outreach Care Specialist I/II/Sr:
This position 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.
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.
Provides education to members regarding all services available.
Participates in cross-functional teams on projects, initiatives, and process improvement activities.
High school diploma or equivalent,
4 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.
Bilingual candidates preferred.
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