Community Health Navigator

Title: Community Health Navigator

Location: Durham United States

Job Description:

Work Arrangement

• This role is remote however candidates must reside in or very near Durham, NC
• 50% of time will be spent traveling

Responsibilities

Member Outreach:

• Assists the LTSS member population with scheduling of in-home PCS assessments
• Collaborates with Personal Care Agencies, Home Health Agencies, and physicians' offices to coordinate the LTSS member needs
• Establishes connection and acts as the primary ACFC contact to a targeted member population, including some high-risk members, through home visits and outreach calls
• Exercises judgment and discretion in the coordination of care by handling basic care follow up tasks and collaborating with AmeriHealth Caritas care management teams, community-based health care providers, and other organizations
• Informs members of the required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach, through phone calls or home visits, and encourages them to comply
• Assists in addressing members' barriers to care and to encourage/foster relationships with their medical/dental providers (medical/dental homes)

Community Education:

• Develops and maintains relationships with new and established community organizations via phone, mail, e-mail, or personal visits
• Collaborates with internal departments and external agencies to obtain data that is pertinent to the overall success of health education/promotion programs
• Provides education to members and member representatives regarding available benefits

Education and Experience

• Associate's Degree in Health Care, Human Services, or a related field or equivalent work experience required
• Bachelor's Degree preferred
• Minimum of 2 (two) years of health care in an office/clinic/hospital setting or human services experience
• Experience in a Physician's office highly preferred
• Experience with LTSS population highly preferred

Skills & Abilities

• Comprehensive knowledge of Microsoft Office Suite and all of its functionality (Word, Excel, Teams, Power Point, Outlook)
• Thorough understanding of database management and documentation systems
• Community based care experience preferred
• Previous experience in presenting health education materials to individuals and small groups
• Knowledge and understanding of medical terminology, disease processes, and behavioral health conditions
• Ability to effectively communicate preventive health and health management philosophies to member's and agencies
• Comprehensive knowledge of Medicaid requirements and plan, policies and procedures
• Knowledge of managed care

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more.