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C&S STARS Member Navigator - Jackson, MS Telecommute

12/07/2018Call Center
Job Location:
Jackson, MS
Metro Area:
MS - Jackson
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
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.SM 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. Primary Responsibilities:Locate members who need guidanceOutreach 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 NavigatorIn 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 goalsCreate a positive experience and relationship with the memberMay focus primarily on conducting health risk assessments with membersIf assigned health plan members to assist in completion of recommended screenings and tests:Inquire if members need help with any specific barriers to healthcareIdentify health plan resources or local community resources to provide solutions for 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 Rx or home delivery via mailProactively 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 UHG staff / programs)Knowledge and continued learning of community cultures and values


Required Qualifications: 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) in a professional setting Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated areaMust reside within a 25 mile radius of zip code 39201, Jackson, MSMust be able to travel 25 - 75% of the time Preferred Qualifications: Bachelor's Degree (or higher)Bilingual (English and Spanish) Experience working in Managed Care Knowledge of Medicaid and 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: UHG, Jackson, MS, Insurance, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group
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