Job details
Job type full-time
Full job description
If you want to achieve more in your mission of health care, you have to be really smart about the business of health careChallenge yourself, your peers and our industry by shaping what health care looks like and doing your life`s best work.(sm)
You push yourself to reach higher and go furtherBecause for you, it’s all about ensuring a positive outcome for patientsIn this role, you’ll work in the field and coordinate the long-term care needs for patients in the local communityAnd at every turn, you’ll have the support of an elite and dynamic teamJoin unitedhealth group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our patients.
The office of individual and family affairs child and member liaison is responsible for member advocacy and system navigation of behavioral health services and social services and supportsThis role is to communicate and disseminate information to members and families to identify concerns and remove barriers that affect service delivery or member satisfactionThe oifa member liaisons collaborate with the organization’s other member support areas, including but not limited provider services, member services as well as working cross collaboratively with all internal departments.
If you are located within the arizona you will have the flexibility to telecommute* as you take on some tough challenges.
Primary responsibilities:
Provide advocacy and system navigation of behavioral health services and social services and supports
Build partnerships with individuals, families, youth, and key stakeholders to promote recovery, resiliency, and wellness
Oversee the provision of, and ensure the availability of, peer support services and family support services by having access to reports to monitor, track, and trend these services
Assist members and their families by answering questions, providing program information and education about care coordination program services, network and community resources and coverage determination guidelines
Identify as participates in internal/external learning opportunities, utilizes available resources and promote use of educational materials and web-based information
As appropriate, consult with family members, health plan, existing providers, and primary care physicians regarding patients` treatment needs and goals and to facilitate proper coordination of care
Fields calls, emails, concerns, and request for assistance addressing members and their families issues.
Assists in development of member facing materials and works cross-functionally internally regarding member facing resources/materials utilizing recovery focused/person center language as it relates to children’s/family services
Attends community forums/provider councils to engage, educate and gather member feedback on system issue improvement.
Support outcome-focused, evidenced-based best practices and guidelines with providers
Provide consultation to providers and/or members on a variety of issues including benefit information, safety issues, confirmation of prior authorizations/ approvals, procedures for higher level of care evaluations, and requests for an explanation of the level of care, coverage determination, or best practice guidelines
Understand benefits in compliance with plan inclusions, limitations, and state/federal mandates
Meet all documentation audit standards
Participate in other duties assigned based on the needs of the health plan
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:
2+ years of experience in behavioral health
Proficiency with microsoft office suite programs (word, outlook, internet)
Reliable transportation with the ability to accommodate some field-based travel within the service delivery area (up to 50%)
Preferred qualifications:
Experience with special populations, including i/dd, (others - student/school systems, etc.)
Dual diagnosis experience with mental health and substance abuse
Community based experience
Experience working in an environment that required coordinating benefits and utilizing multiple groups and resources for members and their families
Previous experience working in a managed care organization (mco)
Familiarity of publicly funded healthcare and social service systems and medicaid eligible or enrolled populations
Familiarity with recovery and resiliency model
Demonstrated familiarity and experience with the current diagnostic and statistical manual and best practice standards for treatment
Knowledge of or ability to research and connect with community resources, including ability to utilize features of search engines as well as intranet to discern available resources for any caller
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status .
Careers at unitedhealthcare community & stateChallenge brings out the best in usIt also attracts the bestThat`s why you`ll find some of the most amazingly talented people in health care hereWe serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, hiv/aids and high-risk pregnancyOur holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factorsJoin usWork with proactive health care, community and government partners to heal health care and create positive change for those who need it mostThis is the place to do your life`s best work.(sm)
*all telecommuters will be required to adhere to unitedhealth group’s telecommuter policy.
Diversity creates a healthier atmosphere: unitedhealth group is an equal employment opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Unitedhealth group is a drug-free workplaceCandidates are required to pass a drug test before beginning employment.
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