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Job Details

UnitedHealth Group

Community Outreach Specialist (Bilingual Spanish), Community Plan - Worcester, MA


Clinical Care Specialist/Staff Nurse



Worcester, Massachusetts, United States

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

You never thought your career could help millions of lives. Well, here you can. As a Community Outreach/MassHealth Eligibility Specialist, you'll utilize innovative strategies and programs to ensure access to health care coverage for the underserved and impact millions of lives. You'll use your energetic, empathetic approach to marketing and add value to our team. Through community marketing and outreach efforts, you will have direct impact on membership growth and retention.

If you are located in Worcester, MA, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • This is an hourly paid/non-exempt role working in the field
  • Maintain detailed knowledge of State and Federal insurance programs and effectively utilize such programs to insure all eligible are enrolled in appropriate MassHealth programs
  • Maintain detailed knowledge of MassHealth and attend all required MassHealth training forum meetings
  • Assist in eligibility determination and completion of MassHealth applications
  • Monitor, analyze, and investigate pending applications and follow up as necessary
  • Interview all prospects/members and authorized representatives to screen for eligibility and obtain vital information for purpose of completion and MassHealth determination
  • Work with individual and/or family to obtain all required documentation for purpose of completion and MassHealth determination
  • Maintain proper documentation
  • Assist existing members with MassHealth Renewal process
  • Support the Sales/Marketing team by facilitating MassHealth applications for purpose of enrollment
  • Support existing COR team by conducting community events when needed
  • Establish new relationships and maintain existing ones by leveraging the MassHealth Eligibility program
  • Conduct educational presentations to community organizations
  • Responsible for meeting or exceeding targeted growth, retention, and enrollment expectations
  • Provide explanations and interpretations within area of expertise
  • Share our mission to help people live healthier lives, throughout the communities we service

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:

  • A state life/health insurance license is a requirement for this position by law. If you do not already have one, must be willing to obtain a (company-sponsored) state health/life insurance license within 60 days of hire
  • Working knowledge of MassHealth/Massachusetts Medicaid and/or Medicare
  • Valid driver’s license with good driving history
  • Access to insured and reliable transportation that will enable you to travel to client and/or patient sites within a designated area
  • Ability to travel up to 75% of the time within this Worcester MA market area
  • Work core business 40 hours Monday – Friday and weeknight and weekends when required by business
  • Bilingual Spanish
  • Live in/with commutable distance to Worcester, MA
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state, and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Bachelor’s or Master’s degree
  • Active health insurance license
  • Experience enrolling members into MassHealth
  • Community Outreach experience within healthcare industry
  • Familiar with One Care
  • Experience working with disabled or seniors in long-term care LTSS, or nursing homes

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers 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.(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 workplace. Candidates are required to pass a drug test before beginning employment.