Community Health Navigator

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 healthcare 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. We'd like to hear from you if you want to make a difference.

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 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 : 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 coordinating care by handling basic follow-up tasks and collaborating with AmeriHealth Caritas care management teams, community-based healthcare providers, and other organizations.

Informs members through phone calls or home visits of the required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach and encourages them to comply.

Assists in addressing members' barriers to care and encourages / fosters relationships with their medical / dental providers (medical / dental homes).

Conduct assessments and information and referrals via plan specific needs.

Community Education :

Develop and maintain 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 pertinent to the overall success of health education / promotion programs

Provides education to members and member representatives regarding available benefits

Work Arrangement : Remote with required travel to include state wide coverage, residing in Kent County preferred

Education / Experience :

Associate's Degree in Health Care, Human Services, or a related field or equivalent work experience (Behavioral Health or Substance Abuse) required

Bachelor's Degree preferred

Minimum of 2 (two) years of health care in an office / clinic / hospital setting or human services experience

Experience with Behavioral Health and / or Substance Abuse Disorder population is preferred

Other Skills :

Comprehensive knowledge of Microsoft Office Suite and its functionality (Word, Excel, Teams, PowerPoint, Outlook)

Thorough understanding of database management and documentation systems (EMR 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 members and agencies

Comprehensive knowledge of Medicaid requirements and plan, policies and procedures

Knowledge of managed care

50% of time will be spent traveling

Valid Drivers License and reliable transportation required

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.

As a company, we support internal diversity through :

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.