Outreach Care Specialist II

Nursing Jobs


Mid Level


Not defined

10 Jun → 10 Jul


Miami, FL, USA

About Company

Your Talent. Our Vision. At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, Join us and together we will drive the future of health care.
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Job Description

This is an exceptional opportunity to do innovative work that means more to you and those we serve.

The Outreach Care Specialist II will serve as the initial and main point of field contact between Simply, our providers, and current and potential members.

This is a work from home position but will need to reside in the Miami/Broward area due to face to face visits in provider offices.

Job Responsibilities

  • Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
  • Meets members in clinic to help identify social determinants of health, impacting patient’s health and general well-being.
  • Identifies barriers to plan compliance and coordinates resolutions.
  • Serves as preceptor for new associates and participates in or leads projects with cross-functional teams.
  • Collaborates with social worker and/or care manager to develop action plan.
  • Works with front desk staff, provider, and member to act as a liaison between the health plan, the member and the provider.
  • Provides superior quality outcomes by taking ownership of issues to ensure timely resolution or follow-up.
  • Coordinates identification of and referral to local, state or federally funded programs. Coaches members on ways to reduce health risks.
  • Prepares reports to document membership trends for providers.
  • Documents interactions with patients and providers.
  • Establishes and maintains relationships with agencies identified in appropriate contract.
  • Comprehends the various cultural and linguistic needs of the Medicaid population, knowledge of the various health and social services available in the assigned region with a special emphasis on services offered by community based organizations, ability to work professionally with the company's associates, community-based organizations, providers and plan members.
  • Attends meetings as required.

Requirements / Qualifications

  • Requires a high school diploma; 3 years 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.
  • 1 year of experience in a healthcare, community-based, or social work environment; or any combination of education and experience, that would provide an equivalent background preferred.
  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • Required Internet Speed: 20 mbps download/5 mbps upload.

Benefits/What We offer

  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs
  • Medical
  • Dental
  • 401(k) +match
  • Short and long term disability benefits

How To Apply

Apply through GoRemotely.

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