Outreach Care Specialist -- (provider Office) Anthem Marianna
Outreach Care Specialist -- (provider Office)
Short Description :
Assistant CMA is preferred BA/BS in a related field is preferred Coordinates identification of and referral to local, state or federally funded programs Assesses member compliance with medical treatment plans via ,…
Full Description :
SHIFT: Day Job SCHEDULE: Full-time Your Talent. Our Vision. At Simply Healthcare, a proud member of the , 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 healthcare. This is an exceptional opportunity to do innovative work that means more to you and those we serve. LOCATION: You will work from key provider offices in Regions 1 and 2, and will serve as a liaison between the health plan, the provider and our member. Florida residency is required. HOURS: Approximately 8:30 am5:30 pm, Monday thru Friday. Actual hours are determined by the provider's hours of operation. The Outreach Care Specialist I is 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.
Florida residency is required.
Requires a high school diploma; BA/BS in a related field is preferred.
Requires 1 year of related experience; or any combination of education and experience, which would provide an equivalent background.
Certified Nurse Assistant (CNA) or Certified Medical Assistant (CMA) is preferred.
Bilingual English-Spanish language skills are preferred.
Experience in care and/or case management experience is preferred.
Knowledge of Medicaid/Florida Healthy Kids and/or Medicare is preferred.
Customer care experience is preferred.
Ability to commute daily to a provider office is required.
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
You must be competent in Microsoft Word, Excel and Outlook.
, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2019 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran.