Outreach Care Specialist Lead at Elevance Health

Washington, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

H.S. diploma or equivalent and 5 years of related experience; or any combination of education and experience which would provide an equivalent background
Reside in Klickitat or Skamania counties, Washington (minimal travel within these counties is needed)
For URAC accredited areas: strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

Responsibilities

Ensures that appropriate member treatment plans are followed on the most complex cases
Proactively identifies ways to improve the health of members and meet quality goals
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
Participates in cross-functional teams on projects, initiatives, and process improvement activities

Skills

Care Coordination

Treatment Planning

Member Compliance Assessment

Barrier Resolution

Process Improvement

Case Management

Health Coaching

Program Referral

Report Preparation

Stakeholder Relationships

Cross-Functional Collaboration

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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