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Elevance Health Outreach Care Specialist in Wallingford, Connecticut

Outreach Care Specialist

Location : This is a hybrid role where the time is split between working from home and out in the community/field in Connecticut . Seeking candidates in the Waterbury, Torrington and Danbury, CT area .

The Outreach Care Specialist provides individual and family support to ensure members are connected to community services, resources and the necessary care coordination. Also responsible for promoting clear communication among a care team and treating clinicians to support the members and families. Coordinates member-specific care plans within the network of care. Works collaboratively with ICC staff, families, consumers, community collaborative members, stakeholders and providers to assure the appropriate services are available to designated members. The goal is to achieve the greatest possible independence and quality of life by assessing individual needs and facilitating access to appropriate community services and supports.

How you will make an impact:

  • Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.

  • Assesses member compliance with medical treatment plans via telephone or through on-site visits.

  • Identifies barriers to plan compliance and coordinates resolutions.

  • Identifies opportunities that impact quality goals and recommends process improvements.

  • Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.

  • Coordinates identification of and referral to local, state or federally funded programs.

  • Coaches members on ways to reduce health risks.

  • Prepares reports to document case and compliance updates.

  • Establishes and maintains relationships with agencies identified in appropriate contract.

Minimum Requirements:

  • Requires a high school diploma and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences :

  • Experience and familiarity with community resources in the area.

  • Bilingual candidates preferred.

  • BS/BA degree in a related field preferred.

  • Experience with EHR (electronic health records) systems.

  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

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