Community Health Worker

About This Role

The Community Health Worker assesses, plans, and implements individualized care strategies for members, focusing on appropriate care levels and addressing social determinants of health. This role involves initiating referrals for social service programs and managing care plans as a single point of contact.

Responsibilities

• Create a positive experience and relationship with members
• Proactively engage members to manage their own health and healthcare
• Support members in improving their wellbeing by staying out of the hospital and attending regular primary physician visits
• Help members engage with mental health and substance use treatment as needed
• Provide member education on community resources and benefits
• Partner with the care team (community, providers, internal staff)
• Maintain knowledge and continued learning of community cultures and values
• Communicate health-related information to all stakeholders to ensure quality coordinated care
• Advocate for patients and families to ensure needs and choices are represented and supported by the healthcare team
• Answer incoming phone calls from healthcare providers, addressing benefit, eligibility, billing, authorization, and explanation of benefits inquiries

Requirements

• High School Diploma/GED (or higher)
• 2+ years of experience working within the community health setting in a healthcare role
• Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and ability to use multiple web applications
• Access to a designated quiet workspace in your home with ability to secure Protected Health Information (PHI)
• Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Ability to travel up to 10% of the time for team meetings or company events and when needed, have access to reliable transportation and the ability to travel in this 'assigned area' to visit Medicaid members in their homes and/or other settings

Qualifications

• High School Diploma/GED (or higher)
• 2+ years of experience working within the community health setting in a healthcare role

Nice to Have

• Associate degree (or higher) in a health-related field
• 1+ years of knowledge of the resources available, culture, and values in the community
• Experience working in managed care
• Knowledge of Medicaid/Medicare population
• Working knowledge of medical terminology
• Bilingual Spanish/English

Skills

* Required skills

Benefits

Certifications