Job Description

City/State

Richmond, VA

Work Shift

First (Days)

Sentara Health Plans is hiring an Bilingual (Spanish-Speaking) Member Outreach Representative / Community Health Worker – Medicaid & Medicare – Remote in Richmond, VA

Status: Full-time, permanent position (40 hours)

Standard working hours: 8 am to 5 pm EST, M-F

Location: Remote in Richmond, Virginia. This role supports both field-based and telephonic outreach to members. Travel to the office is required as needed

Job responsibilities:

• Supports pregnant members from pregnancy through 12 months postpartum.

• Makes outbound calls to health plan members (Approx. 20 calls/day and subject to change)

• Manage the inbound calls from the Welcoming Baby phone line

• Educates members about their health plan benefits and available programs.

• Completes health assessments and documents member information.

• Identifies barriers to care (transportation, access issues, understanding of benefits, etc.).

• Encourages members to use preventive services and follow recommended care

• Conducts both telephonic and field/community outreach.

• Educates members on available maternity benefits, programs, and resources.

• Connects members with community resources, classes, WIC, transportation, and other support services.

• Promotes well-child visits and immunizations through the Watch Me Grow program through 15 months postpartum

• Conducts screenings, health assessments, and referrals to appropriate internal teams when additional support is needed.

Education:

• HS – High School Grad or Equivalent REQUIRED

Certification/Licensure:

• Must obtain a Community Health Worker (CHW) certification within 6 months of hire

Experience:

• Customer Relations- 2 years REQUIRED

• Health Coaching – 2 years REQUIRED

• Customer Service- 2 years REQUIRED

• Clerical- 2 years REQUIRED

• Strong proficiency in Microsoft Office

• Active Driver’s license in Virginia

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products, including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs, and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-103330

Talroo – Health Plan

Keywords: Medicaid, Managed Care, Health Plan, Health Insurance, MCO, Member Outreach, Medicare, DSNP, Bilingual, Spanish-Speaking, Community Health Worker, Remote, Richmond, VA, Virginia

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work,Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.