Community Health Worker - Remote in Texas (Hidalgo or Bexar Counties, TX)

UnitedHealth Group•Schertz, TX

6d•$20 - $36•Remote

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 patients 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 determinants of health such as transportation, housing, and food access; link to community supports. Working Schedule: Monday through Friday, 8:00am to 5:00pm CST If you reside in the counties of Hidalgo or Bexar within Texas, you’ll enjoy the flexibility to telecommute as you take on some tough challenges.

Requirements

High School Diploma/GED (or higher)
2+ years of experience working within the community health setting in a health care role
Intermediate level of computer proficiency (including Microsoft office suite) and ability to use 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)
Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Ability to travel up to 10%25 of the time for team meetings or company events
Access to reliable transportation and the ability to travel in this ‘assigned area’ to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices if field based

Nice To Haves

Associate’s Degree (or higher) in a health-related field
Certified Nursing Assistant/Home Health Aide, Certified Medical Assistant
1+ years of knowledge of the resources available, culture, and values in the community
Community Health Worker (CHW) Accreditation
Experience working in managed care
Knowledge of Medicaid/Medicare population
Working knowledge of medical terminology
Bilingual Spanish/English

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 (EG)
benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits)
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%25 adherence to State contract, CMS requirements, and UnitedHealthcare Community Plan Performance and Quality metrics around Conversion Goals. 100%25 adherence to submission timelines of scheduled department reports, assigned metrics and state deliverables.100%25 adherence to submission deadlines on complaints
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, ensuring all federal, state and company regulations, policies, and expectations are followed
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

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.)

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