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.SM
As a 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.
- Locate members who need guidance
- Telephonic and in person outreach
- In person outreach may vary from 25-75%
- Create a positive experience and relationship with the member
- May focus primarily on conducting health risk assessments with members
- If assigned members to assist in completion of recommended screenings and tests:
- Inquire if members need help with any specific barriers to healthcare
- Identify health plan resources or local community resources to provide solutions for the member
- Keep the member out of the hospital by supporting regular visits to their primary physician
- Keep member actively engaged with their primary physician
- Support the member to ensure pick-up of their Rx
- Proactively engage the member to manage their care
- Provide member education
- Support transitions of care
- Help to keep members compliant with their care plans
- Partner with care team (community, providers, internal staff)
- Knowledge and continued learning of community cultures and values
- High School Diploma / GED or higher
- 3+ years of experience working within the community Health setting in a Healthcare role.
- Knowledge of culture and values in the local community.
- Familiarity with the resources available within the community.
- 1+ years outbound patient / member outreach experience, both telephonic and field-based / in-person.
- Experience 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)
- Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area.
- Must reside in one of the following Cleveland County OR Oklahoma County, OK
- Must be able to travel 25-75%
- Bilingual fluency in English and Spanish
- Experience working in Managed Care.
- Knowledge of Medicaid & Medicare populations in your local area.
- Bachelor's Degree (or higher) in Social Work, LPN (Licensed Practical Nurse) licensure, CNA / HHA.
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: UHG, Cleveland County OR Oklahoma County, OK , Insurance, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group