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Bilingual English and Spanish C&S Stars Member Navigator - McAllen, TX

UnitedHealth Group

McAllen, TX
Job Code:
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Job Details

754847 Bilingual English and Spanish CS Stars Member Navigator McAllen TX

Bilingual English and Spanish C&S Stars Member Navigator - McAllen, TX (754847)

Position Description

Position Description:
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.
As a Bilingual C&S Member Navigator you will act in a liaison role with Medicaid 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 guidance
  • Create a positive experience and relationship with 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
  • 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 staff)
  • Knowledge and continued learning of community cultures and values
  • May conduct HRA assessments if needed
Required Qualifications:
  • High School Diploma / GED
  • Comfortable with 25% to 40% of travel
  • 1+ years of outbound patient / member outreach experience, both telephonic and field-based / in-person
  • 3+ years of experience working within the community Health setting in a Healthcare role
  • Experience and familiarity with the community organizations / resources available within the community or counties specified
  • Experience with both telephonic and in-person, proactive patient outreach
  • Knowledge of culture and values in the local community
  • 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)
  • Must reside in McAllen, TX
  • Bilingual English and Spanish
  • Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
Preferred Qualifications:
  • Bachelor's Degree (or higher) in Social Work, LPN (Licensed Practical Nurse) Licensure, CNA / HHA
  • 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 healthcare here. We serve the healthcare 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 Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place to do your life’s best work.
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: Insurance, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group, Central McAllen, TX

Job Details

  • Contest Number754847
  • Job TitleBilingual English and Spanish C&S Stars Member Navigator - McAllen, TX
  • Job FamilyMedical and Clinical Operations
  • Business SegmentCommunity and State

Job Location Information

  • McAllen, TX
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelYes, 50 % of the Time
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

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.

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