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Community Health Worker - Field Based - Las Vegas, NV

UnitedHealth Group

Las Vegas, NV
Job Code:
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Job Details

Community Health Worker - Field Based - Las Vegas, NV(Job Number:718288)

Position Description:

Energize your career with one of Healthcare’s fastest growing companies.  
You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 17 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. 

Positions are responsible for providing clinical and medical management services, including case management, health assessments, interventions, and discharge planning. May identify, coordinate or provide appropriate levels of care under the direct supervision of an RN or MD. This function does not include Health Coach, Health Educator and Health Advocate roles that do not require an RN. Those roles are found in the Wellness Coach Management function.

Primary Responsibilities: 
  • Engage members either face to face or over the phone to have a discussion about their health
  • Review available member service records and relevant documentation (e.g., utilization history, functional level, stratification information, current plan of care)
  • Conduct comprehensive member assessment that includes bio-psychosocial, functional, and behavioral health needs
  • Utilize interviewing techniques and active listening to collect and retain member information and incorporating responses as they are presented to complete assessment
  • Identify when supplemental assessments are needed and conduct supplemental assessments
  • Identify member service needs related to health concerns
  • Identify urgent member situations and escalate to next level when necessary
  • Engage member to participate in the assessment process and collaboratively develop plan of care based on their individual needs, preferences, and objectives
  • Work with members to develop healthcare goals and identify potential barriers to achieving healthcare goals
  • Identify member support systems available and incorporate into plan of care
  • Review plan benefits and identify appropriate programs and services based on heath needs and benefits
  • Integrate health care and service needs into a plan or recommendation for member care and service
  • Collaborate with member to create solutions to overcome barriers to achieving healthcare goals
  • Identify relevant community resources available based on member needs
  • Refer members to appropriate programs and services
  • Facilitate member choice of preferred provider
  • Enroll members into appropriate programs and services
  • Utilize motivational interviewing techniques to help member identify and understand their intrinsic goals and motivate members to engage in positive behavior change
  • Present complex case information to interdisciplinary care team and obtain input into member plans as necessary
  • Coordinate member access to health-related programs, services, and / or providers
  • Coordinate with providers to facilitate member care and / or services
  • Follow up with members to monitor and document completion of plan activities following standard protocols
  • Provide guidance or additional assistance to facilitate execution of plans or recommendations to improve member health
  • Monitor progress toward plan goals through evaluation of the effectiveness of programs and/or services provided
  • Make changes to plans or recommendations based on evaluation outcomes
  • Research member-related health information (e.g., medications, clinical records, policies, benefit information) using internal and external systems
  • Use desk top computer applications (e.g., Microsoft Excel, Microsoft Word, Microsoft Outlook, Office Communicator) to summarize information (e.g., reports) or communicate member information to others.
  • Document information (e.g., assessment information, member interactions, referrals, follow up plans) in relevant computer systems.
  • Navigate multiple applications at once to obtain and / or document member information
  • Learn updates and changes to computer systems / applications and apply to navigate applications effectively
  • Execute and meet performance goals within a virtual environment
  • Navigate Virtual Call Center (VCC) system to receive inbound calls, make outbound calls, and document call time and activity appropriately

Job Clinical & Medical Management
Primary Location US-NV-Las Vegas
Other Location 
Organization Optum Ops-PHM Medicare
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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