Community Health Worker - Remote in Texas

About the position

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Community Health Worker is responsible for assessment, planning and implementing care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care. They also Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services, and manage the care plan throughout the continuum of care as a single point of contact for the member. The coordinator also addresses social determinant of health such as transportation, housing, and food access; link to community supports.

Responsibilities

• Create a positive experience and relationship with the member
• Proactively engage the member to manage their own health and healthcare
• Support the member to improve their wellbeing by staying out of the hospital, and attend regular visits to their primary physician
• As needed, help the member engage with mental health and substance use treatment
• Provide member education on community resources and benefits
• Conduct post discharge activities from hospital facility and support connection to social services
• Partner with care team (community, providers, internal staff)
• Knowledge and continued learning of community cultures and values
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
• Answer incoming phone calls from health care providers (i.e., physician offices, clinics) and identify the type of assistance the provider needs
• Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller
• Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff
• Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends
• Extensive work experience with Medicaid community
• Monitor timely receipt, accuracy, and compliance of State assessments
• Maintain 100% adherence to State contract, CMS requirements, and UnitedHealthcare Community Plan Performance and Quality metrics around Conversion Goals
• Meet State Partner and Internal expectation on timeliness & quality of interactions with members and providers
• Demonstrate compliance in the urgency of all Star+Plus State & internal deadlines
• Act as an advocate for membership and establish effective working relationships with our providers to service our members
• Be responsive to our members (retention & referrals) and providers (contracting retention)
• Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers
• All other duties as assigned

Requirements

• High School Diploma / GED (or higher)
• 3+ years of experience working within the community health setting in a healthcare role
• Intermediate level of computer proficiency including the use of Microsoft Outlook, Teams, Excel, Word, and the ability to navigate through multiple web applications
• Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Reside in the state of Texas

Nice-to-haves

• Bachelor's Degree in social work, licensed practical nurse (LPN), or CNA/HHA
• Ability to create, edit, save and send documents, spreadsheets and emails
• Reside within commutable distance of assigned duties
• Makes member touchpoints
• All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)