Quality Community Health Worker - Remote in Nebraska

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

The CHW partners closely with internal teams, providers, and community organizations to address barriers to care, promote health education, and facilitate timely access to services aligned with HEDIS®, state quality measures, and support Performance Improvement Projects (PIP). Through member-centered engagement, the CHW supports improved care coordination, transitions of care, and adherence to recommended treatment and follow-up. This role may require travel up to 50% of the time within the community with a home-based office. You will meet members where they are, in their homes, hospitals, clinics, or community settings-to build trust, assess needs, and provide hands-on support. Success in this role requires flexibility, strong communication skills, cultural competency, and the ability to adapt to diverse and complex member situations.

If you are located in Omaha, Nebraska, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

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

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

Preferred Qualifications:

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

*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 $36.00 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.

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