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SalaryAt 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 Member Guardian Advocate/ Ombudsman is responsible for being the voice of our New Mexico Medicaid members within UnitedHealthcare. This person will be actively involved with the community, and expert on Medicaid Member rights, and will work daily to solve member problems within our organization.
If you live in New Mexico, you’ll enjoy the flexibility to work remotely * as you take on some tough challenges.
Primary Responsibilities:
- Coordination and completion of projects across various functional areas including but not limited to member, state, and provider complaints. Monitors and insures timely resolution
- Acts and an impartial point of contact for members who have concerns which may be related to access to services, health plan attentiveness, and personal rights/responsibilities under Turquoise Care
- Advocates for New Mexico Medicaid population within UnitedHealthcare
- Coordinates and drives improvement projects across UnitedHealthcare Community and State New Mexico
- Creates clear and concise written and oral communication, including presentations to management, that details project status, risks, issues, scope, and timeline
- Provides weekly / monthly trending reports to leadership
- Attends state partner rule making sessions
- Attends community listening sessions
- Acts as expert on member rights under Turquoise Care
- Identifies systemic issues within the health plan and broader organization; escalates and tracks to resolution
- Monitors public opinion of UnitedHealthcare within New Mexico and raises concerns to leadership as appropriate
- Acts as the face of UnitedHealthcare within the community, responding to questions or concerns with polish and confidence
- Coordinates operational NPS initiatives with functional owners
- Reviews and edits member facing material for clarity, function, and contractual compliance
- Works directly with plan Chief Operating Officer, Project Management & Analytics, Chief Medical Officer, Senior Quality Director, Health Services Directors, Chief Financial Officer, and Compliance
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.
Years of post-high school education can be substituted/is equivalent to years of experience.
Required Qualifications:
- 3+ years in project/program management experience
- Proficiency with MS Office, including Word, Excel, and Outlook
- A history of advocacy for disadvantaged or marginalized populations
- Knowledge of the New Mexico Medicaid population
- Designated workspace inside the home with access to high - speed internet availability
- Currently reside in New Mexico
- Ability to travel 25% of the time
Preferred Qualifications:
- Experience in Managed Care
- Social Work, Community Health Worker, or Care Coordination experience
- Experience working with tribal entities and indigenous populations
- Communications or Public Relations experience
- Excellent customer service skills
- Solid writing skills and effective communication, including delivering presentations
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
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 workplace. Candidates are required to pass a drug test before beginning employment.
