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Lead Outreach Care Coordinator

2 months ago

Merrillville, Indiana, United States Elevance Health Full time

Position Overview: Senior Outreach Care Specialist

Role Type: This position is primarily community-oriented and field-based. We are seeking candidates from specific regions.

The Senior Outreach Care Specialist is vital in ensuring that members' treatment strategies are meticulously followed in complex scenarios while actively seeking methods to improve the health and wellness of our members, all while meeting quality standards.

Key Responsibilities:

  • Organizes follow-up care requirements by scheduling appointments or enrolling members in necessary programs.
  • Assesses member compliance with medical treatment plans through phone interactions or in-person visits.
  • Identifies barriers to adherence and implements effective solutions.
  • Recognizes factors affecting quality metrics and proposes improvements in operational processes.
  • Recommends modifications to treatment plans and evaluates the need for additional services, collaborating with case management and healthcare providers.
  • Connects members with government-funded programs available at various levels.
  • Advises members on strategies to reduce health risks.
  • Compiles reports to document case specifics and compliance advancements.
  • Develops and maintains relationships with pertinent agencies as outlined in contractual agreements.
  • Informs members about the comprehensive range of services available.
  • Participates in interdisciplinary teams focused on projects and initiatives aimed at process enhancement.

Required Qualifications:

  • A high school diploma along with a minimum of 4 years of relevant experience; or a combination of education and experience that provides an equivalent background.

Preferred Skills and Experience:

  • Certification as a nurse assistant or medical assistant and/or a BS/BA degree in a related discipline is highly preferred.
  • Bilingual candidates are encouraged to apply.
  • Knowledge of behavioral health and physical health conditions is advantageous.
  • Familiarity with electronic health records is beneficial.