Community Health Navigator at Amerihealth Caritas

, District of Columbia, United States -

Full Time

Start Date

Immediate

Expiry Date

16 Oct, 26

Salary

0.0

Posted On

18 Jul, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Member Outreach, Case Management, SDOH Identification, Care Coordination, Community Education, Medical Terminology, Medicaid Requirements, Managed Care, Preventive Health Communication, Relationship Management

Industry

Hospitals and Health Care

Description

Work Arrangement: This is a hybrid position working in our DC office located at 1201 Maine SW. 4 days in office / 1 day remote Responsibilities will include moderate or low risk member case load. As well as the following: Member Outreach: Establishes connection and acts as the primary ACFC contact to a targeted member population, including some high-risk members, through home visits and outreach calls. Identifies SDOH needs and addresses them appropriately. Exercises judgment and discretion in coordinating care by handling basic care follow-up tasks and collaborating with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations. Informs members of the required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach through phone calls or home visits and encourages them to comply. Assists in addressing members’ barriers to care and encourages/fosters relationships with their medical/dental providers (medical/dental homes). Community Education: Develops and maintains relationships with new and established community organizations via phone, mail, e-mail, or personal visits. Collaborates with internal departments and external agencies to obtain data that is pertinent to the overall success of health education/promotion programs. Provides education to members and member representatives regarding available benefits. Education/Experience: Associate’s Degree in Health Care, Human Services, or a related field or equivalent work experience required. Minimum of 1 (one) year of health care in an office/clinic/hospital setting or human services experience. Community-based care experience preferred. Knowledge and understanding of medical terminology and disease processes. Ability to effectively communicate preventive health and health management philosophies to members and agencies. Comprehensive knowledge of Medicaid requirements and plan, policies, and procedures. Knowledge of managed care. Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Your career starts now. We’re looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us atwww.amerihealthcaritas.com.

Responsibilities

The role involves conducting member outreach and home visits to identify social determinants of health and coordinate care with providers. Additionally, the navigator develops relationships with community organizations to provide health education and promote available benefits.