Anthem, Inc. Outreach Care Specialist II in Las Vegas, Nevada
SHIFT: Day Job
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.
Given Anthem’s scale, balance sheet, broad national reach and depth at the local market level, Anthem has established a new business unit called the Diversified Business Group. The Diversified Business Group is a solutions-oriented business unit within the Company that will support Anthem and other external clients in the pursuit of transforming healthcare.
Responsible for ensuring that appropriate member treatment plans are followed on moderately 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.
Serves as preceptor for new associates and participates in or leads projects with cross-functional teams.
Requires a high school diploma;
3 years 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.
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Healthcare industry experience preferred.
Call center experience a plus.
Medicaid experience preferred.
Bilingual candidates preferred.
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. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.