Outreach Care Specialist I
Core
Ensures appropriate member treatment plans are followed for less complex cases and proactively identifies ways to improve member health and meet quality goals.
Role type
Outreach Care Specialist (Care Coordination)
Builds
Member health outcomes and compliance with treatment plans
Domain
Healthcare / Home and Community-Based Services
Required skills
Clinical referral management, care coordination, member compliance assessment, barrier identification, process improvement, medical record auditing, program referral coordination, health risk coaching, report preparation, agency relationship management
Preferred skills
Certified Nurse Assistant (CNA) or Certified Medical Assistant (CMA), Bachelor's degree in related field, referral management experience, bilingualism, clinical systems experience
Technologies
Electronic Medical Record (EMR), Care Management Systems, Population Health Management Systems, Microsoft Office
Responsibilities
Initiates and manages clinical referrals and orders; coordinates follow-up care plans and appointments; assesses member compliance via telephone or on-site visits; identifies barriers to compliance and coordinates resolutions; recommends treatment plan modifications; prepares reports for case and compliance updates; participates in cross-functional process improvement teams; establishes relationships with contracted agencies.
Seniority
Entry-level, individual contributor