Outreach Care Specialist Sr
DescriptionSHIFT: Day Job
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.
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.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
- High school diploma
- Minimum of 4 years 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
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.