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Outreach Care Specialist (Behavioral Health) - New York, NY - PS3034 in New York, NY at Anthem, Inc.

Date Posted: 3/14/2018

Job Snapshot

Job Description

Outreach Care Specialist (Behavioral Health) - New York, NY - PS3034
Your Talent. Our Vision. At Empire Blue Cross, Inc., a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

  • Speak to members and link members to participating providers
  • Follow up with members to make sure no barriers to appointment
  • Complete and track Single Case Agreements and identify provider gaps to work with Provider Relations.
  • Build a “preferred provider” list so members can be linked to providers timely
  • Support BH Member Services with member calls who need additional support.
  • Direct crisis calls to clinicians and triage calls of clinical nature to a clinician
  • Review daily census and notify the outpatient clinicians if any members the expanded benefits programs are hospitalized
  • Review pended authorization  report for new out-of-network  requests or new expanded benefit requests and alerting clinicians of outstanding  requests that need to be completed
  • Generate authorization letters and call members and providers regarding approved authorizations
  • Serve as a resource for provider referrals for other BH teams
  • Monitor fax queue and notify clinicians of received faxes

Job Requirements

  • Requires a high school diploma and/or GED.
  • 1 year of related experience; or any combination of education and experience, which would provide an equivalent background.
  • BA/BS degree in a related field preferred.
  • Bilingual candidates preferred.
  • Behavioral Health experience highly preferred.
  • Data entry experience is preferred.
  • High level customer service experience is preferred.
Anthem, Inc.  is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2017 DiversityInc magazine Top 50 Company for Diversity.  To learn more about our company please visit us at .  EOE.M/F/Disability/Veteran.