Outreach Care Specialist

Elevance Health

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

Posted 11/4/2026full-timeUnited StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in managing clinical referrals, coordinating care plans, and assessing member compliance with treatment plans. Proficient in utilizing clinical systems and Microsoft Office to support quality goals and process improvements.

Highest-signal resume keywords

Clinical Referral ManagementDME Ordering ExperienceElectronic Medical Record ProficiencyExcellent Verbal And Written CommunicationBilingual Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Systems ExperienceCare ManagementPopulation Health ManagementMedical Record AuditsTreatment Plan ModificationsHealth Risk CoachingProcess ImprovementAppointment SchedulingCompliance AssessmentReport Preparation

Soft Skills

Ability To Manage Multiple TasksClear And Concise CommunicationRelationship Building

Tools & Technologies

Microsoft OfficeWordExcelPowerPointOutlook

Certifications & Qualifications

H.S. Diploma Or EquivalentBS/BA Degree PreferredPTA/OTA Preferred

Industry Keywords

HEDISStar ProgramVendor ManagementInsurance CompaniesLocal, State, Or Federally Funded Programs

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 by telephone or through 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 referral 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 and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background
BS/BA degree in a related field preferred
PTA/OTA with at least one year of experience preferred
Minimum 1 year of DME ordering experience preferred
Experience dealing with vendors and insurance companies preferred
Ability to manage multiple tasks at one time
Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
Minimum 2 years’ 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 and convey complex or detailed information understandably
Ability to understand and interpret complex clinical information
Bilingual candidates preferred
Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law

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, except for required in-person training sessions