Anthem, Inc. Outreach Care Specialist in San Antonio, Texas
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 care companies and a Fortune Top 50 Company.
Outreach Care Specialist
Location : Texas, Virtual /Remote (El Paso, permanently remote; all other Texas cities: Temporarily remote due to COVID-19)
Hours: Monday through Friday, 8am to 5pm
The Outreach Care Specialist is 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.
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 candidates preferred.
Internet Connectivity requirements-Line of Site Internet service or 3G and 4G data plans.
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Experience working with STAR PLUS or LTSS programs preferred.
Experience making outbound calls in a call center environment a plus.
Experience in a medical office, health insurance, pre-certification, or claims/billing environment preferred.
Microsoft Office experience preferred.
What We Offer
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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.