Community Health Worker jobs at Community Health Plan of Washington - 17 jobs

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Maintain collaborative relationships with Health & Family Services, government agencies, community resource and advocacy groups, to build additional community support for current and potential enrollees. Work effectively with internal staff, staff at local and state government agencies, and with contracted health plans and regulatory/accreditation entities to develop and implement processes to better serve enrollees Establish and maintain key community relationships throughout State Develop and implement appropriate policy and procedure to ensure health plan staff are able to facilitate enrollee and provider needs through entire case management cycle Communicate, identify, resolve, and prevent care problems, with other systems of care, as well as government and community agencies. Monitor and report on achievement of committed action plans Facilitate on-going communication between the health plan, provider community, and Health & Family Services Coordinate outreach activities to identify enrollees needing care within the urban and rural populations Compile and review reports on work function activities for statistical, financial and process improvement tracking purposes to identify trends, assist in financial forecasting, and make recommendations to management Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives Ensure compliance with State law and regulations Additional responsibilities for LHCC (LA) only for DOJ positions: Will serve as the LHCC representative for this program with the state Participate in MCO workgroup meetings to review and make appropriate changes to the LDH-approved guidance documents for this program to include but not limited to: agency standard operating procedure, training guidelines, assessment tools, care plan templates, and follow-up progress notes. Serve as the point of contact for our delegated PASRR vendor Contribute to monthly reporting for PASRR submitted to LDH Perform quality checks on PASRR documentation submitted by vendor before sending to LDH Ensure timelines for PASRR completion are adhered to Collaborate w/ LDH/OBH PASRR liaison Attend state transition coordination meetings as needed Other duties as assigned Additional responsibilities for Trillium Community Health Plan / Oregon Market: Serve as point of contact for communicating with members, the community, Traditional Health Worker (THW) Workforce, stakeholders, and internal department regarding THW services. Implement and maintain THW integration and Utilization Plan in collaboration with key stakeholders. Create and lead THW Workforce Advisory Committee at Trillium level to advise their work activities and create two-way communication, bi-directional learning, and collaboration with the THW workforce in their service area. Outreach to current and future employers of THWs and work with them to improve THW recruitment and retention. Assisting supervisors and managers with understanding the THW care model, scope of work, and their oversight responsibilities as well as ensuring THWs Providers are integrated into a member's care team and the THW services an integral component of a member's health care Treatment Plan. Integrate THWs into the delivery of services. Assess barriers to integration and utilization of THWs and their services. Facilitate/promote education to health on understanding the THW core roles, and skills, and their oversight responsibilities as well as ensuring THWs Providers are integrated into a member's care team and the THW services an integral component of a member's health care Treatment Plan. Assist members with utilizing THW services across all settings. Provide technical assistance to THWs regarding certification, recertification, and assisting with THW enrollment and billing. Support development and promote adoption of sustainable, THW-specific Medicaid reimbursement processes for THWs that can be used across a variety of settings (clinc, hospital, community-based organizations, schools etc.). Partner with THW worker type-specific professional associations and other THW Liaisons from other Coordinated Care Organizations (CCOs) statewide and community partners to build shared annual work plans, deploy trainings and facilitate community coordination that is responsive to stakeholder needs. Maximize opportunities for collaboration, shared learning. Create detailed reports of project progress as required by CCO contract regulations. Ensure timely submission of all THW deliverables to the Oregon Healthcare Authority (OHA). Develop and work closely with marketing on THW communications and materials to members, providers, and community-based organizations. Performs other duties as assigned Complies with all policies and standards Candidate must live in NC Highly Preferred Skills & Experience Proven success in partner-facing roles Strong community engagement Community advocacy Strong communication skills Deep understanding of social issues Bilingual Spanish, French, Creole a plus 50% Travel and 50% Remote supporting Region 6 (26 counties) Candidate must live in NC, Region 6 Education/Experience: Bachelor's degree in Social Work, Nursing, or related field. 5+ years of social services or advocacy experience preferably in Medicaid environment. License/Certification: LCSW or RN license preferred. Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Do you have a **bachelor's degree** and are ready for a meaningful career where you can make an impact and improve lives? Join us as a Behavioral Health Customer Service Advocate- an inbound call center role focused on helping people access needed care. You'll support members and providers seeking services for mental health and/or substance use disorders. This position features a structured work schedule with a designated queue time. Using empathy, active listening, multitasking, and problem-solving skills, you'll help ensure every caller's experience with Evernorth is both efficient and compassionate. **Key Responsibilities:** + Take back-to-back phone calls from members and providers (calls last about 8-10 minutes). + Triage and conduct intake for risk of harm and substance use concerns + Communicate eligibility, assist with scheduling appointments and providing referrals, quote benefits, and advise on authorization requirements + Utilize resources and independent judgment to deliver accurate information, exceptional service, and resolution on the first call + Collaborate with matrix partners and coordinate seamless handoffs to clinical teams for timely support + Navigate multiple systems and applications across multiple screens while on calls (sometimes up to 9 programs at once) **Requirements:** + **Bachelor's degree** in psychology, social work, or a related field, **or** bachelor's degree in another field plus 2+ years of behavioral health experience. + Customer service experience + Strong time management and multitasking abilities + Proficiency with typing and PC usage + Must remain at your workstation while handling calls from a phone queue **Training schedule** : Monday-Friday, 8:30 AM-5:00 PM CST **Work schedule** : a permanent 8-hour shift between the hours of 7am-7pm CST will be offered based on business need. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here (********************************************** . **About Evernorth Health Services** Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _*********************_ _for support. Do not email_ _*********************_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Act as the liaison regarding the delivery of behavioral health and/or physical health services to Native Americans. Responsible for providing development and training to Native American Tribes. Maintain database inputs and extract monthly reports reflecting trends and patterns in reported incidents. Assist community with prevention and awareness. Make recommendations for investigations, follow •ups and/or corrective actions. Conduct interviews and site visits to discuss cultural needs. Requires extensive travel to rural communities and remote areas Develop and communicate physical and/or behavioral health programs as applicable to the members of Native American Tribes. Answer general questions regarding applicable policies, procedures, and statutes. Offer assistance and make presentations on new materials. We are seeking a Tribal Liaison to join our team! The ideal candidate will bring expertise in: Must Reside in Washoe County, NV 70% Field Work 30% Travel Comprehensive Knowledge of Native American Cultures Experience Working with Tribal Leaders and Community Members Excellent Customer Service and Communication Skills Education/Experience: Bachelor's degree in related field or equivalent experience in Behavioral Health, Public Health, Health Care Administration, Social Work or Nursing. 3+ years of related experience. Experience with and comprehensive knowledge of Native American cultures. Experience communicating with Tribal Leaders and Community Members regarding the needs of Native Americans. Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of OptumHealth. We are looking for someone with solid analytical skills, who can think critically. The perfect candidate is flexible, detail oriented, able to see the big picture, can work within and across multidisciplinary teams, build relationships and has a positive personality. We are seeking lifelong learners who stay up to date on regulations, industry trends and advancements in the field, in addition to constantly developing their personal skillset. Our team members are sought out as a valued experts by our case partners, accounts, and customers. *****Required schedule is Monday-Friday, 10:30am - 7:00pm CST***** You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Extensive work experience, possibly in multiple operational areas + Manage a challenging role in a fast - paced environment + Achieve timely resolution to urgent and non - urgent issues, most of our issues turn around in 48hrs + Synthesize and communicate complex information in understandable terms both verbally and written + Support issue resolution for a variety of internal and external customers + Critically analyze issues from multiple angles to determine the root cause and next steps + Analyze issues including conducting a root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management and issue resolution partners + Able communicate effectively with state agencies, regulators, external customers, clinical medical directors, and senior leadership + Utilize expertise to support issue resolution + Collaborate and coordinate across multiple teams, departments, and representatives + Recognize trends with escalated issues and identity, carry out or coordinate preventative action + Develop effective working relationships with the applicable internal and external customers + Ability to conduct quick and thorough in-depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.) + Work independently + Mentor and develop other team members + Hold others accountable for resolution activities + Review the work of others to assess accuracy with process requirements + Develop innovative approaches to issue resolution + Providing member advocacy including serving as a primary point of contact for members who require assistance with their healthcare needs + Reviewing and resolving complex claims issues, investigating claim discrepancies, and collaborating with the claims processing teams + Understanding medical and behavioral health terminology, treatment options, and guidelines 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:** + Behavioral Health Clinical licensure - independently clinically licensed (i.e., LPC, LCSW, LMFT, LMHC, etc.). + 5+ years of behavioral health care experience + 3+ years of customer service experience in the healthcare industry + Proven knowledge of or State and Federal regulations that govern commercial health insurance + Proficiency with computer and Windows PC applications + Proficiency with Linx, ICUE, OCM + Designated workspace and access to install secure high-speed internet via cable/DSL in home **Preferred Qualifications:** + Experience with or a willingness to learn behavioral health appeals/claims + Optum Care Advocacy or UM experience + Assessment and Triage experience *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Part time - Per Diem - Onsite Health Coach - Miami FL Bilingual Spanish strongly preferred **Evernorth Workplace Care** offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually. **Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live.** Our Evernorth Workplace Care solution isn't a one-size-fits-all model. Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience. Evernorth Workplace Care - Personalized Care Where You Are Our experienced Health Coach will: - Provide onsite face-to-face customer coaching and support - Identify customer health education needs through targeted health assessment activities. - Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals. - Empower customers to become an active participant in their own health outcomes. - Assist Customer in overcoming barriers to better health - Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars. - May perform biometric screenings, including finger sticks, blood pressure, body composition, etc. - Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes. - Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc. **Qualifications** : - Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion - Bachelor's degree in a health-related field. Master's degree preferred. - Registered Dietitian licensed in respective state is preferred - CPR/BLS certification through the American Red Cross or American Heart Association is required. - High energy level, with dynamic presentation skills is required. - Positive role model in demonstrating healthy behaviors - Passion for health improvement - Ability to work independently - Customer-centric focus - Ability to proactively collaborate professionally with the client and other matrix partners. - Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients. - Proven administrative abilities, with strong computer and software application skills. - Bilingual Spanish is preferred **Bonus points for** : - CHES (Certified Health Education Specialist) - Motivational interviewing training/experience. - Smoking cessation and diabetes experience. This position is based in person, in Miami Florida. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. **About Evernorth Health Services** Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _*********************_ _for support. Do not email_ _*********************_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. This position will be working in Region 4 (Lafayette area). Applicants will cover and must reside in one of the following parishes: Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin and Vermillion 75-80% travel is required for this role conducting Member Visits and Participating in Community Events. Position Purpose: Works with care management team on community resource connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and works with the care team to identify member community support and provide health education as appropriate. Provides ongoing support to members to connect them to known community and care resources in a cost-effective manner Supports the coordination of community outreach resources available to members and promotes awareness of care/services Serves as experienced support for members on community and care resource inquiries and opportunities available to members Utilizes in-depth knowledge of community resource connection activities and resource opportunities Supports member related correspondence and educational materials to assist in the facilitation of a successful community connection Works with care management team on escalating community resource requests and inquiries to management and identifying member community support Documents and maintains community resources to ensure standards of practice and policies are in accordance with health plan requirements Provides support to the clinical team of nurses and social workers with activities including, but not limited to outreach, community education, evidence-based guidance, and member support Conduct non-clinical general health assessments in order to refer members to appropriate services, resolve concerns on member's behalf, and gather information for medical providers and staff working within the organization Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate services, resolve concerns on member's behalf, and gather information for medical providers in staff working within our organization Conduct telephonic and/or in-person outreach to locate individuals and families in the community who are hard to reach May make visits to individual homes and/or community organizations Working Knowledge of Social Determinants of Health (SDOH) barriers Performs other duties as assigned Complies with all policies and standards This position will be working in Region 4 (Lafayette area). Applicants will cover and must reside in one of the following parishes: Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin and Vermillion 75-80% travel is required for this role conducting Member Visits and Participating in Community Events. Education/Experience: Requires a High School diploma or GED Requires 2 - 4 years of related experience Pay Range: $20.39 - $34.71 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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. The Community Health Worker is responsible for assessment, planning and implementing care strategies that are individualized by patients and directed toward the most appropriate, least restrictive level of care. They also Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services, and manage the care plan throughout the continuum of care as a single point of contact for the member. The coordinator also addresses social determinants of health such as transportation, housing, and food access; link to community supports. Working Schedule: Monday through Friday, 8:00am to 5:00pm CST If you reside in the counties of Hidalgo or Bexar within Texas, you'll enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: * Create a positive experience and relationship with the member * Proactively engage the member to manage their own health and healthcare * Support the member to improve their wellbeing by staying out of the hospital, and attend regular visits to their primary physician * As needed, help the member engage with mental health and substance use treatment * Provide member education on community resources and benefits * Conduct post discharge activities from hospital facility and support connection to social services * Partner with care team (community, providers, internal staff) * Knowledge and continued learning of community cultures and values * Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members * Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team * Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type of assistance the provider needs (EG) * benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits) * Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller * Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff * Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends * Extensive work experience with Medicaid community * Monitor timely receipt, accuracy and compliance of State assessments. Maintain 100% adherence to State contract, CMS requirements, and UnitedHealthcare Community Plan Performance and Quality metrics around Conversion Goals. 100% adherence to submission timelines of scheduled department reports, assigned metrics and state deliverables.100% adherence to submission deadlines on complaints * Meet State Partner and Internal expectation on timeliness & quality of interactions with members and providers * Demonstrate compliance in the urgency of all Star+Plus State & internal deadlines * Act as an advocate for membership and establish effective working relationships with our providers to service our members, ensuring all federal, state and company regulations, policies, and expectations are followed * Be responsive to our members (retention & referrals) and providers (contracting retention) * Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers * All other duties as assigned What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* 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: * High School Diploma/GED (or higher) * 2+ years of experience working within the community health setting in a health care role * Intermediate level of computer proficiency (including Microsoft office suite) and ability to use multiple web applications * Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) * Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service * Ability to travel up to 10% of the time for team meetings or company events * Access to reliable transportation and the ability to travel in this 'assigned area' to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices if field based Preferred Qualifications: * Associate's Degree (or higher) in a health-related field * Certified Nursing Assistant/Home Health Aide, Certified Medical Assistant * 1+ years of knowledge of the resources available, culture, and values in the community * Community Health Worker (CHW) Accreditation * Experience working in managed care * Knowledge of Medicaid/Medicare population * Working knowledge of medical terminology * Bilingual Spanish/English * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

Who we are: Our commitment is to: Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. * Strive to apply an equity lens to all our work. * Reduce health disparities. * Create an equitable work environment. About the Role Works with and supports members with various chronic conditions in achieving an optimal state of health. The Health Coach will assist, promote and support self-management goals and interventions by providing support, education, and coaching to members with chronic conditions, and collaborating with the member, providers, and internal team members. To be successful in this role, you: * Have a bachelor's degree in a relevant field, or an equivalent combination of education and highly relevant experience, required. * Possess a current, unrestricted license in the state of Washington as an LPN, RN, RD, or other relevant licensure preferred. * Possess a relevant certification, including Health Coach, or Certified Diabetes Care and Education Specialist (CDCES), preferred. * Have a minimum of two (2) years experience in disease management, diabetes education, or health coaching, preferred. * Previous experience in Managed Care, Medicare, and/or Medicaid, preferred. * Experience with Motivational Interviewing, preferred. Essential functions and Roles and Responsibilities: * Provide disease specific care management interventions to promote self- management education and coaching to members enrolled in Diabetes Management programs. * Responsible for the assessment of members, including identifying and coordinating access to the appropriate providers, level of care, and treatment. Uses the assessment information to triage and assign the appropriate risk and complexity level, and create and measurable plan of care, in coordination with the member and their health care team. * Document all member goals, clinical data, outcomes, interactions, assessments, care plans, interventions, and related administrative details in the organization's clinical database system in accordance with organizational policies and procedures. * Assesses barriers to care and assist members and health care team to address concerns. * Collaborate with members and the multidisciplinary team to develop and implement individualized plans of care that consider physical, behavioral, cultural, psychosocial, spiritual, age-specific, and educational needs; coordinate and communicate care activities to ensure continuity, engage community resources and DME as appropriate, and advocate for members to support their goals and promote optimal functioning. * Assess, identify, and implement interventions to meet HEDIS measures * Serves as a liaison at various local and statewide meetings and/or workgroups and provides clinical support to providers' network to enhance integrated care coordination. * Assist in updating policies, procedures, workflows, educational materials, and digital content, and contributes to department projects. * Provide education for the community through health fairs, speaking at local organizations, collaboration with external stakeholders, and collaboration with internal stakeholders through websites and social media platforms, and seminars * Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. Knowledge, Skills, and Abilities: * Knowledge of nutrition, exercise, and disease management. * Knowledge of HEDIS measures. * Ability to build trust with members and assist them in developing positive behavioral lifestyles to improve their health. * Skilled in motivational coaching. * Effective written and verbal communication skills. * Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data. * Skilled in planning and goal setting. * Effective active listening and empathy skills. * Ability to handle multiple priorities. * Proficient in Microsoft Office. Able to perform all functions of the job with accuracy, attention to detail and within established timeframes As part of our hiring process, the following criteria must be met: * Complete and successfully pass a criminal background check. Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. * Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency. * Vaccination requirement (CHPW offers a process for medical or religious exemptions) * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Non-Exempt and is eligible for overtime. Based on market data, this position grade is 45 and has a 5% annual incentive target based on company, department, and individual performance goals. Salary determined at offer will be based on labor market data and a candidate's years of relevant work experience and skills relevant to the position. CHPW offers the following benefits for Full and Part-time employees and their dependents: * Medical, Prescription, Dental, and Vision * Telehealth app * Flexible Spending Accounts, Health Savings Accounts * Basic Life AD&D, Short and Long-Term Disability * Voluntary Life, Critical Care, and Long-Term Care Insurance * 401(k) Retirement and generous employer match * Employee Assistance Program and Mental Fitness app * Financial Coaching, Identity Theft Protection * Time off including PTO accrual starting at 17 days per year. * 40 hours Community Service volunteer time * 10 standard holidays, 2 floating holidays * Compassion time off, jury duty pay. Sensory/Physical/Mental Requirements: Sensory*: * Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: * Extended periods of sitting, computer use, talking and possibly standing. * Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion. * Frequent torso/back static position; occasional stooping, bending, and twisting. * Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching. Mental: * Frequent decision-making. Ability to gather and assess data, determine appropriate actions, apply protocols and knowledge to unique situations, problem-solve and provide consultation. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. * The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Applicants must reside in Oregon, preferably in Lane County. Position Purpose: Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports the care team to identify member community support and provide health education as appropriate. Provides support to members to connect them to known community and care resources in a cost- effective manner Supports the coordination of community outreach resources available to members and promotes awareness of care/services Serves as support for members on community and care resource inquiries and opportunities available to members Supports all member related correspondence and educational materials to assist in the facilitation of a successful community connection Documents and maintains all community resources to ensure standards of practice and policies are in accordance with health plan requirements Provide assistance to the clinical team of nurses and social workers. Activities include, but are not limited to outreach, community education, informal guidance and member support Conduct non-clinical general health assessments in order to refer members to appropriate care/services, resolve concerns on member's behalf, and gather information for medical providers and staff working within the organization Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate care/services, resolve concerns on member's behalf, and gather information for medical providers in staff working within our organization Conduct telephonic and/or in-person outreach to locate individuals and families in the community who are hard to reach May make visits to individual homes and/or community organizations Working Knowledge of Social Determinants of Health (SDOH) barriers Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a High School diploma or GED Requires 1 - 2 years of related experience Pay Range: $17.50 - $27.50 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Part time - Per Diem - Onsite Health Coach - Miami FL Bilingual Spanish strongly preferred Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually. Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live. Our Evernorth Workplace Care solution isn't a one-size-fits-all model. Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience. Evernorth Workplace Care - Personalized Care Where You Are Our experienced Health Coach will: • Provide onsite face-to-face customer coaching and support • Identify customer health education needs through targeted health assessment activities. • Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals. • Empower customers to become an active participant in their own health outcomes. • Assist Customer in overcoming barriers to better health • Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars. • May perform biometric screenings, including finger sticks, blood pressure, body composition, etc. • Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes. • Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc. Qualifications: • Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion • Bachelor's degree in a health-related field. Master's degree preferred. • Registered Dietitian licensed in respective state is preferred • CPR/BLS certification through the American Red Cross or American Heart Association is required. • High energy level, with dynamic presentation skills is required. • Positive role model in demonstrating healthy behaviors • Passion for health improvement • Ability to work independently • Customer-centric focus • Ability to proactively collaborate professionally with the client and other matrix partners. • Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients. • Proven administrative abilities, with strong computer and software application skills. • Bilingual Spanish is preferred Bonus points for: • CHES (Certified Health Education Specialist) • Motivational interviewing training/experience. • Smoking cessation and diabetes experience. This position is based in person, in Miami Florida. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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. As a Field Based Community Health Worker (CHW), 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. CHW's work in a team - based structure and spend the majority of their time in the community engaging directly with members. Interesting in learning to work with medically complex patients who may be experiencing significant addiction and / or behavioral health conditions is important for this role. Expect to spend about 50% of your time in the field visiting our members in their homes or in long-term care facilities, in the King, Pierce, or Snohomish Counties, WA region. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Scheduled: Monday - Friday with some evening and weekend hours to attend community events. If you reside near King, Pierce, or Snohomish counties, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: * Create a positive experience and relationship with the member * Proactively engage the member to manage their own health and healthcare * Provide member education on community resources and benefits * Support member to engage in work or volunteer activities, if desired, and develop solid social supports through deeper connections with friends, family, and their community * Engages members primarily face to face or over the phone to discuss their need for provider follow up * Creates a positive experience and relationship with the member to drive Quality performance within our assigned membership. * Conducts outreach to encourage participation in health-related programs, services, and/or providers * Engages patients by driving to the homes of the unable to reach population * Utilize strong skill sets of managing multiple tasks at a time, being self-motivated, driven toward quality results, managing time well, being very detailed oriented and organized, work well in a team and on your own, and ability to manage multiple deadlines * Knowledge and continued learning of community cultures and values What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * High School Diploma/GED (or higher) * 1+ years of experience in local community-based resources * Intermediate level of proficiency in MS Word, and Outlook * Resident of Washington state * Designated workspace inside the home with access to high-speed internet * Ability to travel in assigned territory approximately 50% of the time with your own means of transportation * Available to work Monday through Friday, 8 AM to 5 PM and open to working some evenings and weekend hours for events * Access to reliable transportation & valid US driver's license Preferred Qualifications: * Bachelor's degree in social work, licensed practical nurse (LPN), MA/CNA/HHA or HS graduate with 1 year of experience working within the community health setting in a health care role * One of the following credentials/experiences: * Licensed Practical Nurse (LPN) * Certified Nursing Assistant (CAN) * Home Health Aide * Certified Medical Assistant * Social work experience * CHW Accreditation * 2+ years of community outreach work experience * 2+ years of field-based experience * Knowledge and/or experience with behavioral health or substance use disorders * Care management experience * Experience working in Managed Care * Experience with EHR * Knowledge of Medicaid and / or Medicare population * Bilingual Spanish and English * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED

Onsite Health Navigator - Health Coach - Madison AL Hours will be 3 shifts of (Mon, Tues, Thurs) 11 am - 8 pm and 2 shifts of (Wednesday, Friday) 7:00 - 4 pm.. Here's more on how you'll make a difference: • Provide onsite face-to-face customer coaching and support • Identify customer health education needs through targeted health assessment activities. • Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals. • Empower customers to become an active participant in their own health outcomes. • Assist Customer in overcoming barriers to better health • Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars. • May perform biometric screenings, blood pressure, body composition, etc. • Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes. • Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc. What we expect from you: • Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion • Bachelor's degree in a health-related field. Master's degree preferred. • Current ACLS/BLS/CPR/AED Certification • High energy level, with dynamic presentation skills is required. • Positive role model in demonstrating healthy behaviors • Passion for health improvement • Ability to work independently • Customer-centric focus • Ability to proactively collaborate professionally with the client and other matrix partners. • Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients. • Proven administrative abilities, with strong computer and software application skills. Bonus points for: • Behavioral Health experience including stress reduction • CHES (Certified Health Education Specialist) • Motivational interviewing training/experience. This role is based on-site in Madison AL. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of OptumHealth. We are looking for someone with solid analytical skills, who can think critically. The perfect candidate is flexible, detail oriented, able to see the big picture, can work within and across multidisciplinary teams, build relationships and has a positive personality. We are seeking lifelong learners who stay up to date on regulations, industry trends and advancements in the field, in addition to constantly developing their personal skillset. Our team members are sought out as a valued experts by our case partners, accounts, and customers. * Required schedule is Monday-Friday, 10:30am - 7:00pm CST* You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Extensive work experience, possibly in multiple operational areas * Manage a challenging role in a fast - paced environment * Achieve timely resolution to urgent and non - urgent issues, most of our issues turn around in 48hrs * Synthesize and communicate complex information in understandable terms both verbally and written * Support issue resolution for a variety of internal and external customers * Critically analyze issues from multiple angles to determine the root cause and next steps * Analyze issues including conducting a root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management and issue resolution partners * Able communicate effectively with state agencies, regulators, external customers, clinical medical directors, and senior leadership * Utilize expertise to support issue resolution * Collaborate and coordinate across multiple teams, departments, and representatives * Recognize trends with escalated issues and identity, carry out or coordinate preventative action * Develop effective working relationships with the applicable internal and external customers * Ability to conduct quick and thorough in-depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.) * Work independently * Mentor and develop other team members * Hold others accountable for resolution activities * Review the work of others to assess accuracy with process requirements * Develop innovative approaches to issue resolution * Providing member advocacy including serving as a primary point of contact for members who require assistance with their healthcare needs * Reviewing and resolving complex claims issues, investigating claim discrepancies, and collaborating with the claims processing teams * Understanding medical and behavioral health terminology, treatment options, and guidelines 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: * Behavioral Health Clinical licensure - independently clinically licensed (i.e., LPC, LCSW, LMFT, LMHC, etc.). * 5+ years of behavioral health care experience * 3+ years of customer service experience in the healthcare industry * Proven knowledge of or State and Federal regulations that govern commercial health insurance * Proficiency with computer and Windows PC applications * Proficiency with Linx, ICUE, OCM * Designated workspace and access to install secure high-speed internet via cable/DSL in home Preferred Qualifications: * Experience with or a willingness to learn behavioral health appeals/claims * Optum Care Advocacy or UM experience * Assessment and Triage experience * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

**Onsite Health Navigator - Health Coach - Madison AL** Hours will be 3 shifts of (Mon, Tues, Thurs) 11 am - 8 pm and 2 shifts of (Wednesday, Friday) 7:00 - 4 pm.. **Here's more on how you'll make a difference** : - Provide onsite face-to-face customer coaching and support - Identify customer health education needs through targeted health assessment activities. - Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals. - Empower customers to become an active participant in their own health outcomes. - Assist Customer in overcoming barriers to better health - Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars. - May perform biometric screenings, blood pressure, body composition, etc. - Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes. - Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc. **What we expect from you** : - Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion - Bachelor's degree in a health-related field. Master's degree preferred. - Current ACLS/BLS/CPR/AED Certification - High energy level, with dynamic presentation skills is required. - Positive role model in demonstrating healthy behaviors - Passion for health improvement - Ability to work independently - Customer-centric focus - Ability to proactively collaborate professionally with the client and other matrix partners. - Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients. - Proven administrative abilities, with strong computer and software application skills. **Bonus points for** : - Behavioral Health experience including stress reduction - CHES (Certified Health Education Specialist) - Motivational interviewing training/experience. This role is based on-site in Madison AL. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. **About Evernorth Health Services** Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _*********************_ _for support. Do not email_ _*********************_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._

Do you have a bachelor's degree and are ready for a meaningful career where you can make an impact and improve lives? Join us as a Behavioral Health Customer Service Advocate- an inbound call center role focused on helping people access needed care. You'll support members and providers seeking services for mental health and/or substance use disorders. This position features a structured work schedule with a designated queue time. Using empathy, active listening, multitasking, and problem-solving skills, you'll help ensure every caller's experience with Evernorth is both efficient and compassionate. Key Responsibilities: Take back-to-back phone calls from members and providers (calls last about 8-10 minutes). Triage and conduct intake for risk of harm and substance use concerns Communicate eligibility, assist with scheduling appointments and providing referrals, quote benefits, and advise on authorization requirements Utilize resources and independent judgment to deliver accurate information, exceptional service, and resolution on the first call Collaborate with matrix partners and coordinate seamless handoffs to clinical teams for timely support Navigate multiple systems and applications across multiple screens while on calls (sometimes up to 9 programs at once) Requirements: Bachelor's degree in psychology, social work, or a related field, or bachelor's degree in another field plus 2+ years of behavioral health experience. Customer service experience Strong time management and multitasking abilities Proficiency with typing and PC usage Must remain at your workstation while handling calls from a phone queue Training schedule: Monday-Friday, 8:30 AM-5:00 PM CST Work schedule: a permanent 8-hour shift between the hours of 7am-7pm CST will be offered based on business need. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Health Coach - Behavioral Health - Bilingual Spanish - Dallas TX Our Custom Coaching program connects employees with a highly skilled wellness coach for face-to-face (or video/telephonic) sessions. Coaches take a holistic approach to help employees set and accomplish goals, manage chronic conditions and encourage healthy behaviors. We are seeking a compassionate and skilled Behavioral Health Coach to support individuals in achieving their mental well-being and personal development goals. This role focuses on guidance, motivation, and skill-building rather than clinical diagnosis or therapy. As a coach, you will empower clients to navigate life's challenges, enhance resilience, and build healthy habits through a whole-person approach to behavioral health. Here's more on how you'll make a difference with our patients: • Provide one-on-one and group coaching and support to individuals in areas such as stress management, emotional well-being, self-care, and personal growth. • Identify customer health education needs through targeted health assessment activities, to include screenings for depression, anxiety and stress. • Utilize evidence-based techniques like motivational interviewing, cognitive behavioral strategies, and mindfulness practices to encourage behavioral change. • Collaborate with clients to set achievable goals and action plans tailored to their needs. Empowering clients to become an active participant in their own health outcomes. • Identify when clients may need clinical intervention and refer them to appropriate care when necessary. • Assist Customer in overcoming barriers to better health. • Utilize biometric values and motivational interviewing techniques to collaborate with customers to drive to improve clinical outcomes. • Lead and support a variety of Health and wellness promotional activities to include, delivering educational workshops, wellness programs, or digital content to support behavioral health initiatives. • Provide support for health-related site events, which include open enrollment, wellness committee facilitation, health fairs, etc. • Maintain accurate and confidential client records in accordance with company policies and ethical guidelines. • Stay informed on the latest behavioral health research, coaching methodologies, and best practices. Required Qualifications: • Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion with a behavioral health focus. (Experience in coaching, counseling, wellness or behavioral health settings.) • Bachelor's Degree required in a health-related field. Behavioral health focused degree (psychology, social work, behavioral science or public health) preferred. • Master's degree preferred • Current ACLS/BLS/CPR/AED Certification or ability to obtain during onboarding • High energy level, with dynamic presentation skills is required. • Positive role model in demonstrating healthy behaviors • Passion for health improvement • Ability to work independently • Customer-centric focus • Ability to proactively collaborate professionally with the client and other matrix partners. • Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients. • Proven administrative abilities, with strong computer and software application skills. • Strong communication, active listening, and motivational skills • Ability to work with diverse populations and tailor coaching approaches accordingly. • Bilingual Spanish • Must reside local to Dallas TX Bonus points for: • Behavioral Health experience including knowledge of trauma-informed care, motivational interviewing, stress management, or holistic wellness approaches • Certification in Health Coaching, Behavioral Health Coaching, Life Coaching, or a related field (e.g., CHES (Certified Health Education Specialist), NBHWC, ICF or similar) This full-time role is based local to Dallas TX. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.