Community Health Care Case Worker (Outreach Specialist)
Vacancy expired!
Responsible for serving as the initial and main point of Field contact between the Company and current and potential members.
Primary duties may include, but are not limited to:
Responds to telephone, written, and in-person inquiries and initiates steps to assist regarding issues relating to content or interpretation of benefits, policies and procedures.
Provides timely and accurate resolution of inquiries and issues regarding benefits, services and policies.
Supports and promotes State Sponsored Programs through participation in community events.
Represents State Sponsored Programs in community collaborations. Supports member access to care through home visits, processing of reports, and distribution of collateral materials.
Performs new member orientations.
Provides superior quality outcomes by taking ownership of issues to ensure timely resolution or follow-up.
Provides superior, professional, and courteous service to customers. Comprehends the various cultural and linguistic needs of the Medicaid and SCHIP population, knowledge of the various health and social services available in the assigned region with a special emphasis on services offered by community based organizations, ability to work professionally with the company's associates, community-based organizations, providers and plan members.
Responsible for providing technical direction, guidance and resources to claims, customer service, or membership associates on a day-to-day basis.
Primary duties may include, but are not limited to:
Serves as a first line resource for operation associates for workflow and technical related processes; provides operational training; assists associates by answering day-to-day technical questions; encourages a teamwork environment; monitors inventory to ensure workflow remains uninterrupted; handles complex case research and resolution; reviews, interprets and maintains records of service level, quality, accuracy, and productivity; reviews department policy and procedure manuals for accuracy; works with training department to ensure procedures and policies are accurate and complete.
Minimum Requirements:
Requires HS Diploma and a minimum of 1 year of customer service experience, or any combination of education and experience that would provide an equivalent background.
Preferred Qualifications:
Understanding of the basic principles of managed care and the concepts of publicly financed health insurance such as Medicaid and SCHIP programs is preferred.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Elevance Health approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.elevancehealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.
