Omaha, Nebraska

Description

SHIFT: Day Job

SCHEDULE: Full-time

Outreach Care Specialist

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.

Qualifications

Requirements

  • Requires a high school diploma; 1 year 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 in Spanish preferred.
  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • Position is work from home: must reside in the State of Nebraska within commutable distance to an Anthem office.
     

Omaha, Nebraska

At Anthem, Inc., we believe that our health connects us all. So we focus on being a valued health partner and delivering quality products and services that give members access to the care they need. With more than 100 million people served by our affiliated companies including approximately 40 million enrolled in our family of health plans, we can make a real difference to meet the needs of our diverse customers.

Website:
Similar jobs