Outreach Care Specialist Lead - Carelon
Core
Ensuring appropriate member treatment plans are followed on complex cases and proactively identifying ways to improve member health and meet quality goals.
Role type
Senior IC care coordination specialist (team lead)
Builds
Member health outcomes and compliance with medical treatment plans
Domain
Healthcare / Care Management
Deliverable
client delivery
Required skills
Case management, treatment plan assessment, barrier identification, program enrollment coordination, report preparation, agency relationship management, team leadership
Preferred skills
Behavioral health or mental health experience, Certified Nurse Assistant (CNA) or Certified Medical Assistant (CMA), Bachelor's degree in related field, bilingualism
Technologies
None explicitly stated
Responsibilities
Coordinate follow-up care plan needs by scheduling appointments or enrolling members in programs; Assess member compliance with medical treatment plans via telephone or on-site visits; Identify barriers to plan compliance and coordinate resolutions; Recommend treatment plan modifications and determine need for additional services; Coordinate identification of and referral to local, state or federally funded programs; Coach members on ways to reduce health risks; Serve as a team lead; Participate in cross-functional teams on projects and process improvement activities
Seniority
Senior, hands-on IC with team lead responsibilities