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.
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Managed Care representative, either certified or uncertified, who acts as an advocate for enrolled members of the Managed Care Plan.
Representative makes outreach attempts to seek and engage Members for the purpose of conducting face to face visits with Members in both facility, community, and home-based settings.
Representative conducts a questionnaire, or Health Needs Assessment, to identify member-specific needs.
Representative refers members for intensive / high case management when high utilization is noted, member has poorly managed chronic conditions, or is at risk for an altered health status due to lack of education.
Representative provides education on health benefits and services provided by Managed Care Plan, and links member with network medical and behavioral providers appropriate to Members stated needs.
Representative provides ER diversion education with access to primary care.
Representative identifies the members need for community-based resources in excess of what is covered by Managed Care Plan, and provides referral information to connect member with potential suppliers of needs.
Representative acts to encourage the completion of health promotion activities, including, but not limited to HEDIS measures.
Representative identifies barriers that may exist to Member care access, and seeks ways to remove barriers (i.e. lack of transportation, homelessness, poverty).
Representative completes delegated tasks set forth by Managed Care Case Management staff.
Representative assists Member to develop a Health Action Plan consistent with their primary health and social-related priorities, Member safety, family/support input as allowed by the Member, and input from health care collaborative team.
Delegation of activities to a Community Health Worker to be monitored by a licensed Registered Nurse, including initial and ongoing direction, procedural guidance, observation, and evaluation.
A Registered Nurse shall be available in person, or by some form of telecommunication, for ongoing and adequate supervision of tasks delegated to the community health worker.
Delegated activities to require no judgment based theoretical or practical knowledge unique to the profession of nursing.
Delegated task must be within the knowledge, training, skill, and ability of the CHW.
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.