Community Health Worker - Remote in Texas

UnitedHealth Group•San Antonio, TX

6h•$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. As a Support Service Coordinator (SSC), you will act in a liaison role with Medicaid members to ensure appropriate care is accessed as well as to provide home and social assessments and member education. SSC’s work in a team-based structure and spend most of their time engaging directly with members. Interesting in learning to work with medically complex patients who may be experiencing significant health conditions is important for this role. Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services. Manage the care plan throughout the continuum of care as a single point of contact. Schedule: This position is full - time (40 hours / week) Monday - Friday. Employees are required to work our 8-hour shift schedules during our normal business hours of 8:00am to 5:00pm. It may be necessary, given the business need, to work occasional overtime. This position is a based position with a home - based office. If you are located in the state of Texas, you will have the flexibility to telecommute as you take on some tough challenges. Preference for those residing in Bexar and Harris County, TX or surrounding areas. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

High School Diploma/GED (or higher)
3+ years of experience working within the community health setting in a health care role
Intermediate level of proficiency with MS Word, Excel (create, edit, save documents) and Outlook (email and calendar management) and the 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)
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Must reside in the state of Texas
Strong communication and customer service skills both in person and via phone
Ability to work independently and maintain good judgment and accountability
Demonstrated ability to work well with others
Strong organizational and time management skills
Ability to multi-task and prioritize tasks to meet all deadlines
Ability to work well under pressure in a fast-paced environment
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

Community Health Worker (CHW) Accreditation
Experience working in Managed Care
Knowledge of Medicaid/Medicare population
Solves routine problems on their own - Works with supervisor to solve more complex problems
Prioritizes and organizes own work to meet agreed upon deadlines
Works with others as part of a team

Responsibilities

Create a positive experience and relationship with the members
Help members set goals and develop a care plan to achieve those goals
Proactively engage the members to manage their own health and healthcare
Support the members 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
Support the member to ensure pick-up of their prescriptions
Provide member education on community resources and benefits
Conduct post discharge activities from hospital facility and support connection to social services
Support members to engage in work or volunteer activities, if desired, and develop stronger social support through deeper connections with friends, family and their community
Partner with care team (community, providers, internal staff)
Knowledge and continued learning of community cultures and values
Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services
Manage the care plan throughout the continuum of care as a single point of contact
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 with 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)
Manage administrative intake of members
Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage
Review requests for adverse determination, approval notification and processing notification requirements
Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

Benefits

In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives.

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