Bilingual English and Spanish C&S Stars Member Navigator - McAllen, TX
April 12, 2018
Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. UnitedHealth Group is working to create the Healthcare system of tomorrow and you can help. Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance Healthcare system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed. Join with us and start doing your life's best work. As a Bilingual C&S Member Navigator 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.Primary Responsibilities:Locate members who need guidanceCreate a positive experience and relationship with the memberKeep the member out of the hospital by supporting regular visits to their primary physicianKeep member actively engaged with their primary physicianSupport the member to ensure pick-up of their RxProactively engage the member to manage their careProvide member educationSupport transitions of careHelp to keep members compliant with their care plansPartner with care team (community, providers, internal staff)Knowledge and continued learning of community cultures and valuesMay conduct HRA assessments if needed
Required Qualifications:High School Diploma / GEDComfortable with 25% to 40% of travel1+ years of outbound patient / member outreach experience, both telephonic and field-based / in-person3+ years of experience working within the community Health setting in a Healthcare roleExperience and familiarity with the community organizations / resources available within the community or counties specifiedExperience with both telephonic and in-person, proactive patient outreachKnowledge of culture and values in the local communityExperience using a computer and Microsoft Office including Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort, filter, and work within tables), and Microsoft Outlook (email and calendar management)Must reside in McAllen, TXBilingual English and Spanish Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated areaPreferred Qualifications:Bachelor's Degree (or higher) in Social Work, LPN (Licensed Practical Nurse) Licensure, CNA / HHAExperience working in Managed CareKnowledge of Medicaid and Medicare populations in your local areaCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in healthcare here. We serve the healthcare needs of low income adults and children with debilitating illnesses such as Cardiovascular Disease, Diabetes, HIV/AIDS and High-risk Pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place to do your life's best work. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Keywords: Insurance, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group, Central McAllen, TX
Internal Number: 754847
About UnitedHealth Group
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.