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Job description
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.
nYour career starts now. We're looking for the next generation of health care leaders.
nAt AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care 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.
nHeadquartered in Newtown Square, 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.
nDiscover more about us at .
nResponsibilities:
nCommunity Education
nnnDevelops and maintains relationships with new and established community organizations via phone, mail, e-mail and personal visits.
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nnCollaborates with internal departments and external agencies to obtain data that is pertinent to the overall success of health education/promotion programs.
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nnProvides education to members and member representatives regarding nursing facility transitions and available benefits.
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n nMember Outreach:
nnnEstablishes connection for Long-Term Services and Supports members, identified as unable to reach through unannounced home visits and outreach calls.
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nnExercises judgment and discretion in the coordination of care by handling basic care follow up tasks and collaborating with AmeriHealth Caritas case management teams, community based health care providers, and other organizations.
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nnPerforms outreach calls to members to identify barriers and/or unmet needs.
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nnInforms 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.
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nnAssists in addressing members' barriers to care and to encourage/foster relationships with their medical/dental providers (medical/dental homes.
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nnCoordinates with Primary Care Physicians for the completion of Comprehensive Medical Reports needed for annual redeterminations.
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nnAssists members with obtaining community resources and DME.
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nnPerforms in-facility assessments on Long-Term Services and Supports members with an interest in transitioning out of the nursing facility.
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nnAssists in the transition of members from the nursing facility to community by assisting to obtain birth certificates, identification cards, social security cards and award letters, shopping for approved household items and sets up those items.
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nnPerforms initial telephonic outreach to new members and acts as a back up to the personal care coordinators.
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nnPerforms tasks as assigned by Long-Term Services and Supports management team to support members.
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nnDocuments contact with members within the case management system.
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n nWork Arrangement: Remote with required travel to include state wide coverage residing in DE.
nEducation/Experience:
nnnAssociate's Degree in Health Care, Human Services, or a related field or equivalent work experience (Behavioral Health or Substance Abuse) preferred.
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nnBachelor's Degree preferred.
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nnMinimum of 2 (two) years of health care in an office/clinic/hospital setting or human services experience.
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n nOther Skills:
nnnCommunity based care experience preferred.
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nnKnowledge of Medicaid requirements and plan, policies and procedures.
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nnKnowledge of managed care.
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nn75% of time will be spent traveling.
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nnPhysical ability to perform tasks that may require prolonged standing, sitting, and other activities necessary to perform job duties such as lifting premium giveaways, educational materials, and household items for set-up.
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nnKnowledge of and experience working with vulnerable populations preferred.
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nnKnowledge of and experience with substance use disorder and behavioral health preferred.
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nnUnderstand how to collaborate with a variety of different people and roles.
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nnShow strong growth mindset and are able to learn from setbacks.
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nnStay focused and organized while juggling multiple deadlines.
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nnAbility to carefully handle confidential or time-sensitive information.
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nnKnowledge and experience with locating housing.
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n nOur Comprehensive Benefits Package
nFlexible 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.
nAs a company, we support internal diversity through:
nRecruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
Worksite address
newtown square, PA, 19073, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.