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 position is responsible for the facilitation, implementation and coordination of the EPSDT Member Outreach Program and the overall compliance with immunization and EPSDT examinations. The position serves as the health plan resource for EPSDT / Well Child Program. This individual will plan, organize, and coordinate all aspects of the EPSDT (Early Preventative Screening Diagnostic Testing) program and ensure compliance of EPSDT with all state and federal requirements and NCQA standards.
If you reside in New Mexico, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities
? Identify and facilitate assistance for member needs specific to maternal/child health and EPSDT
? Create and present quarterly executive summaries on performance data such as the CMS (Centers for Medicare & Medicaid Services) Form 416 EPSDT report
? Provide culturally competent educational resources for health care provider facing staff on EPSDT and related Population Health
? Educate health care providers in their office, and via electronic communication channels, on clinical measures and EPSDT
? Maintain policies and procedures, as well as work plan for EPSDT
? Participate in Performance Improvement Projects, and performance measure campaigns as assigned
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
? 3+ years clinical experience
? 2+ years of clinical experience within the child and pediatric population
? 1+ years of experience with MS Office, including Word, Excel, and Outlook
? Experience presenting to others
? Proven ability to create spreadsheets in Excel
? Willing or ability to travel locally up to 25% of the time
? Reliable transportation and the ability to travel to meet with members and providers
? Currently reside in New Mexico
Preferred Qualifications
? BSN
? Current, unrestricted Registered Nurse (RN) licensure in the state of NM or a compact license allowing you to practice in NM
? Pediatric nursing experience
? Experience with wellness quality metrics related to childhood health screenings
? Experience working with provider offices
? Clinical nursing experience in managed care environment
? Experience working with the Medicaid/Medicare Population
? Experience with EPSDT
? Experience working with providers and members to increase compliance with screenings
? Proven comfort with reading and writing reports and analyzing data
? Proven solid written and verbal communication skills
? 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
