Manager of Clinical Administration/Community Health Workers - Remote in Texas

At UnitedHealthcare, 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 better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

If you are in the state of Texas, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Sets team direction, resolves problems, and provides guidance to members of own team. Impact of work is most often at the team level
• Own output at task level
• Serve as primary point of contact for Providers or Members, regarding Medical/Behavioral/Clinical services or benefits
• Receive calls requesting Medical/Behavioral/Clinical services or Benefits information (e.g., from Providers or Members)
• Receive electronic Referral Form requests for Medical/Behavioral/Clinical services
• Access electronic Member files using policy or identification number
• Determine Member eligibility
• Follow protocols to task requests appropriately
• Check procedure codes against Notification requirements and Benefit coverage to determine next steps
• Reference automated Job Aid tools via the computer to identify appropriate procedures, when needed
• Set priorities for the team to ensure task completion
• Coordinate work activities with other supervisors
• Develop plans to meet short-term objectives
• Identify and resolve Operational problems using defined processes, expertise, and judgment
• Decisions are guided by policies, procedures, and business plan
• Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical requests

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:

• Undergraduate Degree or 2 years of experience working in Medicaid Managed Care
• 2 years of experience working with a vulnerable population in meeting the needs of the Member population served (for example, people with Disabilities)
• 1 years of experience working for an insurance company or business-related setting supporting operations
• 1 years of experience with member outreach
• Intermediate level of proficiency experience in Microsoft Office, including Excel and Word
• Possess knowledge of the principles of most integrated settings, including federal and state requirements like the federal home and community-based settings regulations

Preferred Qualifications:

• 2 years working directly with Long-Term Support Services / Home and Community-Based service providers, Personal Care Management Agencies, and Health Centers
• Demonstrated ability with developing strategic plans, attainable goals, drive performance and achieve targets
• Experience working with the Medicaid population
• Program or Project management experience

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe 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 experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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