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Description SHIFT: Day JobSCHEDULE: Full-timeYour 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 healthcare.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.The Outreach Care Specialist 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.LOCATION: This is a field-based position that will service our members in Colorado, with up to 50% of local travel within an assigned territory. When you are not in the field, you will work remotely from home. Occasional office visits for meetings and/or training are required. HOURS: 8:00 am – 5:00 pm, Monday through Friday.Primary duties may include, but are not limited to:
Identifies opportunities for engagement of members and their families in forming a supportive, recovery network.
Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
Develops and implements provision of onsite psychiatric discharge planning education at Recovery and Resiliency sites.
In collaboration with member, assesses member adherence with their 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.
Qualifications Note: This position may be filled at either the I, II or Senior level. The manager will determine level based upon the selected applicant’s skill-set relative to the qualifications listed for this position.
Requires a high school diploma; BS/BA degree in a related healthcare field is preferred.
1 year of related experience is required, the related experience should include experience in health services, behavioral health, peer support services, or lived experience which would prepare you to assist members in their recovery journey.
This position requires local travel. You must be comfortable visiting members in their homes or in a care facility.
You must have the ability to travel up to 50% in the assigned local territory.
Knowledge of care coordination and case management concepts is preferred.
Peer Support Specialist Certification, Certified Medical Assistant, or Certified Nursing Assistant is preferred.
Bilingual language skills preferred (English-Spanish or other).
You must reside within a commutable distance to an Anthem office.
Experience working with multiple computer systems, along with web-based applications, is required.
Note: 3 years of experience is required for OCS II, and 4 years of experience is required for OCS Sr.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.REQNUMBER: PS35708
Vacancy expired!