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Job Summary

Company
Anthem
Location
Grand Prairie, TX
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS3807

Outreach Care Specialist - Bilingual Preferred, Grand Prairie, TX (PS3807)

About the Job

Description

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's 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.

The Outreach Care Specialist is responsible for high-volume telephonic support for the Texas health plan. Provides support to multiple departments by: troubleshooting issues, providing resources to health plan members, and processing service coordination authorizations. Must have the ability to multi-task and produce quality outcomes within a fast-paced environment.
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.
  • Identifies barriers to plan compliance and coordinates resolutions. Identifies opportunities that impact quality goals and recommends process improvements.
  • Receives treatment plan concerns or need for additional services, in conjunction with Case Management/Service Coordinator and provider.
  • Coordinates identification of and referral to local, state or federally funded programs.
  • Establishes and maintains relationships with agencies identified in appropriate contract.
  • Responsible for responding to inquiries from members and providers to clarify benefits, provide member education and member referrals
Qualifications
  • 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 strongly preferred.
  • Experience working with the Texas STAR + PLUS Medicaid managed care program, Behavioral Health, and/or Intellectual Development Delayed population is preferred

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

 

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