Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Care Advocate role will engage and develop relationships with our members. This role focuses on proactive, best practices, consultation and improvement of quality care for members and/or their caregivers throughout the healthcare continuum. The primary responsibility for member support includes the initial engagement, coordination with our providers, connecting member with various care teams, educating member on pending/current hospitalizations, supporting member through next site of care as well as a 30-day discharge from a facility.

As a Care Advocate , you will act as a resource and advocate for members and their caregivers to ensure an optimal member experience. This position is also responsible for coordination and communication to members, physicians and other care management teams serving as a liaison with external departments to ensure consistent member care. Includes but not limited to managing outgoing/incoming calls, scheduling provider appointments, providing information on available services, managing referral process and transferring members as appropriate to clinical staff.

This position is Sunday - Saturday. Employees can work 4 - 10 hour shifts from 7:00 am - 6:00 pm OR 5 - 8 hour shifts from 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

We offer 4 - 6 weeks of paid training. The hours during training will be 8:00 am - 5:00 pm from Monday - Friday remote.

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

Primary Responsibilities:

• Establishes a trusting relationship with identified members, caregivers, clinic staff and physicians (may be completed face-to-face or virtual with member)
• Proactively engages the member to coordinate their care needs
• Keeps member actively engaged with their primary care physician and assists member with any scheduling medical appointments/transportation; clinical issues or concerns will be directed to a nurse/clinical professional
• Partners with the member’s care team (community, providers, internal staff); serving as a liaison between member and/or caregiver and all health services/processes
• Connects members who need guidance and assistance with any specific barriers to healthcare identified through telephonic outreach with an appropriate care team to assist in solving the member’s needs
• Conducts Social Determinants of Health assessments to identify member needs and connect member with an appropriate care team to assist
• Plans, prioritizes, organizes and completes work to meet established objectives
• Review care history documentation (e.g., case notes); includes navigation between computers screens and platforms to research information (e.g., medical, clinical, or benefits information)
• Serves as primary point of contact for internal and external stakeholders
• Conducts in-bound and out-bound calls including, but not limited to: member touch-points, clinical staff coordination, member scheduling, and/or surveys/screenings
• Enters timely and accurate data into the electronic medical record to communicate member needs and ensure complete documentation of member visits and phone calls
• Periodically may visit members/patients in facility or next site of care, requiring ability to travel reliably to and from location
• Performs all other related duties as assigned

Required Qualification:

• High School Diploma / GED
• Must be 18 years of age OR older
• 3+ years of experience in customer service support and/or engagement
• Ability to interact productively with individuals and with multidisciplinary teams
• Excellent organizational and prioritization skills
• Proficient computer skills, including Microsoft Word, Microsoft Excel, Microsoft Access and Microsoft Outlook
• Ability to work 4 - 10 hours shift from 7:00 am - 6:00 pm OR 5 - 8 hour shifts from 8:00 am - 5:00 pm from Sunday - Saturday

Preferred Qualification:

• Healthcare experience
• Bilingual fluency in English and Spanish
• Knowledge of medical terminology
• Basic understanding of Medicare and Medicaid health plans
• Experience with working with Medicare and Medicaid populations
• Ability to comprehend and retain detailed information
• Excellent verbal and written skills

Telecommuting Requirements:

• Reside within the state of TX
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Physical and Work Environment:

• Ability to lift to 10 pounds
• Ability to push or pull heavy objects using up to pounds of force
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to properly drive and operate a vehicle
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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