Community Health Navigator

Amerihealth
Published
January 8, 2022
Location
Philadelphia, PA
Category
Job Type

Description

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 Philadelphia, 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.

Responsibilities:

As part of the community outreach function, the Community Health Navigator supports the development of and executes on the outreach strategy in a certain territory for the purposes of impacting health outcomes, health care costs, and member engagement.  This position is responsible for establishing and cultivating relationships with members and providerscommunity organizations or area agencies. Based on the territory / market assigned, the Community Health Navigator may be asked to focus in one or all of the below functional areas.      

Community Programs:   

  • Promotes member and public awareness of the importance and the availability of screenings and services for the purposes of supporting healthy lifestyles in efforts and improving HEDIS measures. 
  • Develops and maintains relationships with new and established providers to promote strong partnerships.

Member outreach:

  • 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, STARs, 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).
  • Documents all member encounters/home visitoutcomes and when supporting medical management initiatives, and shares with Supervisor on a weekly basis.
  • Refers members to community resources as needed, provides preliminary health education based on member condition.
  • Evaluates and documents environmental assessment of members’ home conditions and refers to care management as necessary.
  • Engages unable to reach member based on the following medical affairs initiatives: medication adherence, hospital readmissions.
  • Other duties as assigned.

Education/ Experience:

  • Associate’s Degree in Health Care, Human Services or a related field or equivalent work experience. 
  • Candidate must possess a valid driver’s license and be willing and able to drive a car. 50% of time will be spent traveling within Philadelphia, Delaware, Montgomery, and Bucks counties in Pennsylvania.
  • Minimum of 2 years of health care in an office/clinic/hospital setting or human services experience.
  • Community based care experience preferred.
  • Previous experience in presenting health education materials to individuals and small groups.
  • Knowledge and understanding of medical terminology and disease processes.
  • 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.
  • Lifting premium give-aways and educational materials.
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