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Community Health Worker - Field Based - Louisville, KY

UnitedHealth Group

Louisville, KY
Job Code:
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Job Details

Community Health Worker - Field Based - Louisville, KY(Job Number:720288)

Position Description:

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.

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., Excel, Word, 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-KY-Louisville
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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