Outreach Care Specialist I
Elevance Health, Atlanta, GA, United States
Outreach Care Specialist I
CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services.
LOCATION
Virtual eligible role. You should be within a reasonable distance from one of our offices.
HOURS
7:00 a.m. – 4:00 p.m. CT (8:00 a.m. – 5:00 p.m. ET), Monday through Friday
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Primary duties may include, but are not limited to:
Initiates and manages clinical referrals and orders including but not limited to Specialists, Labs and Imaging Centers.
Coordinates follow‑up care plan needs for members by scheduling appointments or enrolling members in programs.
Assesses compliance with medical treatment plans via telephone visits.
Identifies barriers to plan compliance and coordinates resolutions.
Identifies opportunities that impact quality goals and recommends process improvements.
Medical record audit support to support HEDIS/Star program goals.
Coordinates identification of and referral to local, state or federally funded programs.
Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
Coaches members on ways to reduce health risks.
Prepares reports to document case and compliance updates.
Participates in cross‑functional teams on projects, initiatives, and process improvement activities.
Establishes and maintains relationships with vendors and/or agencies identified in appropriate contract.
Required Qualifications
Requires a H.S. diploma or equivalent and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.
Preferred Qualifications
BS/BA degree in a related field preferred.
PTA/OTA with at least one year of experience preferred.
Minimum 1 year of DME ordering experience preferred.
Experience dealing with vendors and insurance companies preferred.
Ability to manage multiple tasks at one time.
Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook).
Minimum 2 years’ experience with clinical systems (electronic medical record, care management, or population health management).
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or detailed information in a manner that others can understand, as well as the ability to understand and interpret complex clinical information from others.
Benefits
Elevance Health offers a range of market‑competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Eligibility and Screening
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member‑facing roles to become vaccinated against COVID‑19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
EEO Statement
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services.
LOCATION
Virtual eligible role. You should be within a reasonable distance from one of our offices.
HOURS
7:00 a.m. – 4:00 p.m. CT (8:00 a.m. – 5:00 p.m. ET), Monday through Friday
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Primary duties may include, but are not limited to:
Initiates and manages clinical referrals and orders including but not limited to Specialists, Labs and Imaging Centers.
Coordinates follow‑up care plan needs for members by scheduling appointments or enrolling members in programs.
Assesses compliance with medical treatment plans via telephone visits.
Identifies barriers to plan compliance and coordinates resolutions.
Identifies opportunities that impact quality goals and recommends process improvements.
Medical record audit support to support HEDIS/Star program goals.
Coordinates identification of and referral to local, state or federally funded programs.
Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
Coaches members on ways to reduce health risks.
Prepares reports to document case and compliance updates.
Participates in cross‑functional teams on projects, initiatives, and process improvement activities.
Establishes and maintains relationships with vendors and/or agencies identified in appropriate contract.
Required Qualifications
Requires a H.S. diploma or equivalent and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.
Preferred Qualifications
BS/BA degree in a related field preferred.
PTA/OTA with at least one year of experience preferred.
Minimum 1 year of DME ordering experience preferred.
Experience dealing with vendors and insurance companies preferred.
Ability to manage multiple tasks at one time.
Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook).
Minimum 2 years’ experience with clinical systems (electronic medical record, care management, or population health management).
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or detailed information in a manner that others can understand, as well as the ability to understand and interpret complex clinical information from others.
Benefits
Elevance Health offers a range of market‑competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Eligibility and Screening
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member‑facing roles to become vaccinated against COVID‑19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
EEO Statement
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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