Position Description: This isn't packaged goods. It's a bigger challenge than that. Here you're making a difference in people's lives, starting with your own. Join us and start doing your life's best work.(sm)A specialized member advocate for individuals with intellectual or other types developmental disabilities in each Grand Region in which the CONTRACTOR serves TennCare members. This member advocate shall be responsible for the internal representation of these members' interests, including, but not limited to, input into planning and delivery of services for individuals with I / DD, including the implementation of the ECF CHOICES program in the Grand Region, program monitoring and evaluation, and member, family, and provider education. The ECF CHOICES Member Advocate is responsible for planning, developing, and operation of the member advocacy program for the UnitedHealthcare Community Plan (UHCCP) TennCare CHOICES Long Term Services and Supports (LTSS) program in a designated Grand Region.Primary Responsibilities:Develops and implements annual plan for TennCare ECF CHOICES Long Term Services and Supports (LTSS) advocacy program and related activities designed meet Contractor Risk Agreement (CRA) requirementsDevelops partnership and collaborates with community agencies, organizations, and faith based institutions to address quality of life issues for LTSS / Intellectual and Developmental Disability (I / DD) membershipFacilitates and manages Member Advisory Group meetings and activities for designated regionRepresent the ECF CHOICES members' interests including, but not limited to, planning and delivery of long-term care services and supports, ECF CHOICES QM / QI activities, program monitoring and evaluation, as well as member, family, and provider educationAssists Care Support Coordinators (csc) to resolve member non-clinical issues and navigation of the health plan. Escalates issues as appropriateWorks to ensure member satisfaction. Identifies member dissatisfaction risks and escalates and / or resolves as appropriateProvides cross coverage of member CHOICES advocacy issues, when other team members are outField based position. Involves time out of the office and travel within the service area.Performs other related functions as assigned
Required Qualifications:Bachelor's degree (or higher) OR High School Diploma / GED with 5+ years experience working with intellectual and developmental disabilities 3+ years experience with development and implementation of services designed to meet the needs of individuals with intellectual and developmental disabilities (I / DD).3+ years experience working with community resources available to individuals with intellectual and developmental disabilities (I/DD) to resolve non clinical quality of life issues.1+ years experience providing community outreach and facilitating member advisory meetings / patient - family councils. Knowledgeable about member benefits of TennCare and Medicare including administration of benefitsDemonstrated ability to work with MS Office, including Word, Excel, PowerPoint50% travel within region Preferred Qualifications:Master's degree or higher Experience working with diverse populations, demonstrating cultural competency and community awarenessSoft Skills: Ability to manage and prioritize multiple tasks efficiently and effectivelyExcellent communication and organizational skills, with ability to speak publiclyAbility to work independently and with teamExcellent customer service skills and professional demeanor necessaryCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SMDiversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Keywords: UnitedHealth Group, UHG, ECF Choices Member Advocate, ECF, social work, medicaid, TennCare, Managed Care, West TN, ECF Choices program, intellectual and developmental disabilities, community resources, developmental disabilities, community outreach
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.