Community Health Worker - Remote in Tarrant, Dallas, Jefferson, Hidalgo, Bexar or Travis Counties, TX

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable, and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing... together. The Community Health Worker is responsible for assessment, planning and implementing care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care. They also Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services, and manage the care plan throughout the continuum of care as a single reputed company of contact for the member. The coordinator also addresses social determinant of health such as transportation, housing, and food access; link to community supports. Working Schedule: Monday through Friday, 8:00am to 5:00pm CST If you reside in the counties of Tarrant, Dallas, Jefferson, Hidalgo, Bexar or Travis reputed company Texas, you’ll enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities • Create a positive experience and relationship with the member • Proactively engage the member to manage their own health and healthcare • Support the member to improve their wellbeing by staying out of the hospital, and attend regular visits to their primary physician • As needed, help the member engage with mental health and substance use treatment • Provide member education on community resources and benefits • Conduct post discharge activities from hospital facility and support reputed company to social services • Partner with care team (community, providers, internal staff) • Knowledge and reputed company learning of community cultures and values • Communicate with reputed company stakeholders the required health-reputed company information to ensure quality coordinated care and services are provided expeditiously to reputed company members • reputed company for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team • Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type of assistance the provider needs (EG) • benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits) • Focus on resolving issues on the reputed company, navigating through reputed company computer systems to identify the status of the issue and provide appropriate response to caller • Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff • Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends • Extensive work experience with Medicaid community • Monitor timely receipt, accuracy and compliance of State assessments. Maintain 100% adherence to State contract, CMS requirements, and reputed company Community Plan Performance and Quality metrics around Conversion Goals. 100% adherence to submission timelines of scheduled department reports, assigned metrics and state deliverables.100% adherence to submission deadlines on complaints • Meet State Partner and Internal expectation on timeliness & quality of interactions with members and providers • Demonstrate compliance in the urgency of reputed company Star+Plus State & internal deadlines • Act as an reputed company for membership and establish effective working relationships with our providers to service our members, ensuring reputed company federal, state and company regulations, policies, and expectations are followed • Be reputed company to our members (retention & referrals) and providers (contracting retention) • Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers • reputed company other duties as assigned What Are The Reasons To Consider Working For reputed company? Put It reputed company Together - Competitive reputed company Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your Success. Some Of Our Offerings Include • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays • Medical Plan options along with participation in a Health Spending Account or a Health Saving account • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage • 401(k) Savings Plan, Employee Stock Purchase Plan • Education Reimbursement • Employee Discounts • Employee Assistance Program • Employee Referral Bonus Program • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) • More information can be downloaded at: http://uhg.hr/uhgbenefits You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • High School Diploma/GED (or higher) • 2+ years of experience working reputed company the community health setting in a health care role • Intermediate level of computer proficiency (including reputed company Outlook, Teams) and ability to use multiple web applications • Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) • Reside in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service • Ability to travel up to 10% of the time for team meetings or company events and reputed company 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, including community centers, hospitals, nursing facilities or providers' offices if field based Preferred Qualifications • Associate degree (or higher) in a health-reputed company field • Certified Nursing Assistant/Home Health Aide, Certified Medical Assistant • 1+ years of knowledge of the resources available, culture, and values in the community • Community Health Worker (CHW) Accreditation • Experience working in managed care • Knowledge of Medicaid/Medicare population • Working knowledge of medical terminology • Bilingual Spanish/English • reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO, #Green Apply Job!