Outreach Care Specialist

Elevance Health

. Initiate and manage clinical referrals and orders, including specialists, labs, and imaging centers .

Posted 11/9/2026full-timeUnited StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in clinical referrals and care coordination, with a strong focus on member compliance and quality improvement initiatives. Proficient in utilizing clinical systems and Microsoft Office to support case management and reporting.

Highest-signal resume keywords

Clinical Referral ManagementCare CoordinationMicrosoft Office ProficiencyElectronic Medical Record ExperienceBilingual Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Referral ManagementCare CoordinationElectronic Medical RecordPopulation Health ManagementReport PreparationProcess ImprovementHEDIS/Star Program SupportAppointment SchedulingTreatment Plan ModificationCompliance Assessment

Soft Skills

Excellent Verbal CommunicationExcellent Written CommunicationCoaching SkillsRelationship BuildingProblem Solving

Certifications & Qualifications

Certified Nurse AssistantCertified Medical Assistant

Industry Keywords

Clinical SystemsHealth Risk ReductionQuality GoalsMember ComplianceCross-Functional Team Participation

About the role

Key responsibilities & impact

Initiate and manage clinical referrals and orders, including specialists, labs, and imaging centers
Coordinate follow-up care plan needs by scheduling appointments or enrolling members in programs
Assess member compliance with medical treatment plans via telephone or on-site visits
Identify barriers to plan compliance and coordinate resolutions
Identify opportunities affecting quality goals and recommend process improvements
Support medical record audits for HEDIS/Star program goals
Recommend treatment plan modifications and determine the need for additional services with case management and providers
Coordinate identification of and referrals to local, state, or federally funded programs
Coach members on ways to reduce health risks
Prepare reports documenting case and compliance updates
Participate in cross-functional teams on projects, initiatives, and process improvement activities
Establish and maintain relationships with agencies identified in appropriate contracts

Requirements

What you’ll need

H.S. diploma or equivalent
Minimum of 1 year related experience, or any combination of education and experience which would provide an equivalent background
Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
Experience with clinical systems (electronic medical record, care management or population health management)
Excellent verbal and written communication skills
Ability to speak clearly and concisely, conveying complex or detailed information in a manner that others can understand
Ability to understand and interpret complex clinical information from others
Ability to work Monday–Friday, 8:00am–5:00pm EST
Must reside within CST or EST time zones
Must be within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law
Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field preferred
Minimum 1-year of referral management and/or care coordination preferred
Bilingual candidates preferred

Benefits

Comp & perks

Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
401(k) + match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Virtual full-time work, with required in-person training sessions
Vaccination coverage/requirement for certain patient/member-facing roles