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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.
Locate members who need guidance
Outreach to members in person who have either had appointments for in person visits scheduled for the Member Navigator, or outreach in person to members for home visits scheduled by the Member Navigator.
In person outreach will be 80%, 4 days per week. Work week will be 5 days per week, with the 5th day focused on documentation and other administrative goals.
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 or home delivery via mail
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 UHG staff / programs)
Knowledge and continued learning of community cultures and values
High School Diploma / GED (or Higher)
1 year 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.
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 be able to travel up to 75%
Bilingual (English and Spanish)
Experience working in Managed Care.
Knowledge of Medicaid & Medicare populations in your local area.
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: Washington, Member, Navigator, UnitedHealth Group, UHG, Snohomish, Community
Unitedhealth Group Inc.