[Hiring] Quality Community Health Worker @UnitedHealth Group

Role Description

As a Quality Community Health Worker (CHW), you will serve as a vital link between the health plan, healthcare providers, and Medicaid members to improve health outcomes, reduce disparities and support contractually required Performance Improvement Projects (PIP). This role focuses on proactive outreach and engagement to support members in completing preventative health screenings, closing gaps in care, and navigating follow-up services after hospitalizations, including behavioral health and substance use–related visits.

• Conduct targeted outreach to members identified through claims data, HEDIS gap reports, and transition-of-care alerts to drive Quality performance improvements and improved health outcomes.
• Connect with members to promote follow-up appointments after emergency department visits and hospitalizations, including behavioral health and substance use-related events.
• Collaborate with internal teams to implement PIP strategies and document outcomes aligned with HEDIS and state quality measures.
• Participate in and support the implementation of quality improvement strategies aimed at enhancing overall health plan performance and outcomes.
• Collaborate with providers, care teams, and community organizations to support coordination of care and timely access to recommended services.
• Assist members in navigating the healthcare system, including scheduling appointments and understanding available benefits.
• Facilitate access to community-based services and resources to address identified needs.
• Conduct assessments of member healthcare, behavioral health, and social needs using available tools and guidance.
• Identify and escalate barriers to care, including social determinants of health (SDOH) and access issues.
• Collect and document member information and communicate relevant updates to care teams to support ongoing care.
• Provide culturally appropriate health education to support preventive care, treatment adherence, and healthy lifestyle choices.
• Encourage and support members in adopting positive health behaviors.
• Advocate for member needs within established processes and escalate concerns as appropriate.
• Participate in community outreach efforts such as health events, screenings, and education initiatives.
• Support implementation of outreach activities in collaboration with internal teams and community partners.
• Accurately document outreach activities, member interactions, and outcomes in designated systems.
• Support quality improvement initiatives by promoting completion of preventive services and identified care gaps.
• Follow established procedures and workflows for tracking and reporting outreach activities.
• Strong multitasking, organization, and time management skills with the ability to meet multiple deadlines and work independently and collaboratively.

Qualifications

• High School Diploma/GED.
• 2+ years of experience working within the Community Health setting within a healthcare role.
• Intermediate level of computer proficiency including Microsoft Outlook, Teams, Excel, Word, etc. and the ability to use multiple web applications.
• The ability to travel in assigned regions to visit Medicaid members in their homes and/or other settings, including community centers, hospitals or provider offices not to exceed 50% of your time and only during regular business hours.
• Must reside in Nebraska.
• Valid Nebraska driver’s license and current automobile insurance with access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area.
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Preferred Qualifications

• Bachelor's degree in social work, licensed practical nurse (LPN), CAN/HHA or HS graduate with 3 years of experience working within the community health setting in a health care role.
• Previous experience working as a Community Health Worker.
• Knowledge and/or experience with behavioral health or substance use disorders.
• Community Health Worker training and/or certification.
• Bilingual in English and other languages.
• Training in motivational interviewing.
• Strong knowledge of local community resources and services.
• Knowledge of Medicaid and working in Managed Care.
• Ability to work with diverse populations.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• Hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment.