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 current Community Health Worker (CHW) position plays a vital role in patient education and engagement for an NCQA accredited program as required by contract. A budgeted replacement is essential to ensure continuity in providing personalized care, managing chronic conditions, and promoting preventive health measures. This position directly contributes to improved patient outcomes and reduced healthcare costs by fostering stronger patient-provider relationships. Position is needed for compliance contract ratios or membership growth. Work is unable to be absorbed by current staff.If you reside within a commutable distance of Youngstown, OH, you will have the flexibility to work remotely as you take on some tough challenges.Primary Responsibilities:
Engage members either face to face or over the phone to have a discussion about their health
Review available member service records and relevant documentation (e.g., utilization history, functional level, stratification information, current plan of care)
Conduct comprehensive member assessment that includes bio-psychosocial, functional, and behavioral health needs
Utilize interviewing techniques and active listening to collect and retain member information and incorporating responses as they are presented to complete assessment
Identify when supplemental assessments are needed and conduct supplemental assessments
Identify member service needs related to health concerns
Identify urgent member situations and escalate to next level when necessary
Engage member to participate in the assessment process and collaboratively develop plan of care based on their individual needs, preferences, and objectives
Identify member support systems available and incorporate into plan of care
Review plan benefits and identify appropriate programs and services based on heath needs and benefits
Integrate health care and service needs into a plan or recommendation for member care and service
Collaborate with member to create solutions to overcome barriers to achieving healthcare goals
Identify relevant community resources available based on member needs
Refer members to appropriate programs and services
Facilitate member choice of preferred provider
Enroll members into appropriate programs and services
Utilize motivational interviewing techniques to help member identify and understand their intrinsic goals and motivate members to engage in positive behavior change
Coordinate member access to health-related programs, services, and/or providers
Coordinate with providers to facilitate member care and/or services Present complex case information to interdisciplinary care team and obtain input into member plans as necessary
Follow up with members to monitor and document completion of plan activities following standard protocols
Provide guidance or additional assistance to facilitate execution of plans or recommendations to improve member health
Monitor progress toward plan goals through evaluation of the effectiveness of programs and/or services provided
Make changes to plans or recommendations based on evaluation outcomes
Provide individualized education on preventative healthcare measures (e.g., immunization, healthcare screening)
Educate members on health and wellness information related to disease processes
Educate member on plan benefits available and/or how to access benefits
Educate members on disease specific signs and symptoms of worsening condition and action to take if they occur
Educate member on appropriate utilization of services based on need (e.g., PCP vs. ER)
Work with internal partners to create a culture of health and wellness that promotes member health
Plan and execute on-site health and wellness programming for members and engage members in available programs
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
Proven ability to use desktop computer applications (e.g., Excel, Word, Outlook, Office Communicator)
Live in Mahoning, Trumbull, Columbiana County area
Preferred Qualification:
Medical background/ knowledge
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.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.
