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.
As a Member Navigator, you will act in a liaison role with United Healthcare Dual Special Needs Community & State members to ensure appropriate care is accessed as well as to provide home and social assessments and member education.
This position is Field Based, and requires up to 75% travel throughout the State of Missouri. The ideal candidate will reside in the one of the following counties or surrounding areas: Clayton, MO OR St. Louis City, MO or surrounding areas
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 health plan 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
1 years of 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
Ability to travel 25% - 75%
Must reside in the one of the following counties or surrounding areas: Clayton, MO OR St. Louis City, MO or surrounding areas
Undergraduate Degree (or higher)
Experience working in Managed Care
Knowledge of Medicaid and Medicare resources available within your local areas
Bilingual (English and Spanish)
Careers 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 health care here. We serve the health care 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 health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM
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, Clayton, MO OR St. Louis City, MO , Insurance, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group
Unitedhealth Group Inc.