Elevance Health - Wauchula, FL
posted 24 days ago
Full-time - Entry Level
Wauchula, FL
11-50 employees
Insurance Carriers and Related Activities
About the position
The Community Outreach Care Specialist plays a crucial role in enhancing the health of members by identifying and coordinating social determinants of health (SDOH) programs. This position supports the Florida Pathways program and focuses on improving member compliance with medical treatment plans, addressing barriers to care, and fostering relationships with relevant agencies.
Responsibilities
- Coordinates SDOH 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.
Requirements
- Requires a H.S. diploma or equivalent and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.
Nice-to-haves
- Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred.
- Bilingual candidates preferred.
- Knowledgeable in social determinants of health interventions (SDOH).
- Excellent customer service skills.
- Ability to manage high caseloads.
- Strong problem solving skills preferred.
Benefits
- $1500 Sign On Bonus
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical, dental, vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
