West Chester, PA, United States
Healthcare, Work At Home
Outreach Care Specialist I-II - Remote (Within 1 hour from any Anthem office) - PS21805
Location: Albany, New York, United States
Requisition #: PS21805
Post Date: 4 hours ago
Your 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 health care.
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.
Outreach Care Specialist I-II
This position will be filled at Level I or II. This will be determined by the hiring manager based on your skills and experience.
Location: This is a remote, work-from-home opportunity; however, you must live within 1 hour of an Anthem office location.
Work Hours: Monday through Friday 8:00am – 5:00pm EST – you must be able to work these EST hours regardless of physical location.
Under direction of the RN CM OCS Senior may assist in ensuring that appropriate member treatment plans are followed.
Primary duties may include, but are not limited to:
Outreach calls and letters to engage members in either Complex CM or PDM Case Management Programs.
Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
Under direction of RN CM helps the RN to identify member compliance with medical treatment plans via telephone.
Identifies opportunities that impact quality goals and recommends process improvements.
Coordinates identification of and referral to local, state or federally funded programs.
Assists the RN with any referrals to internal and external partners.
Prepares reports to document case and compliance updates.
Establishes and maintains relationships with agencies identified in appropriate contract.
Provides education to members via mailed documents.
Participates in cross-functional teams on projects, initiatives, and process improvement activities.
* Additional job responsibilities may be required at the direction of Manager/ Director which may include participation in Audits, Special Projects*
Requires a high school diploma or GED;
1-3 years of related experience (depending on level of hire);
Or, any combination of education and experience, which would provide an equivalent background.
MS Office (Word, Outlook, Excel) experience required
Skills – telephonic, strong communication, time-management, ability to multi-task, ability to work independently
Certified Nurse Assistant or Certified Medical Assistant certification
BS/BA degree in a related field
Experience participating in state or CMS audits and/or other projects
Experience with Care Compass and FACETS
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.
Website : http://www.antheminc.com