Care Advocate

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind 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 members through the 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 is not limited to managing outgoing/incoming calls, scheduling provider appointments, providing information on available services, managing referral processes and transferring members as appropriate to clinical staff.

This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 6 - 8 weeks of on-the-job training. The hours of training will be aligned with your schedule.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. 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 touchpoints, 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 Qualifications:

• High School Diploma OR GED
• Must be 18 years of age OR older
• 4+ years of experience in customer service support and/or engagement
• Excellent verbal and written skills
• Ability to interact productively with individuals and with multidisciplinary teams
• Excellent organizational and prioritization skills
• Proficient computer skills, including Microsoft Word, Excel, Access, and Outlook

Preferred Qualifications:

• Health care experience
• Bilingual in English and Spanish language proficiency
• Knowledge of medical terminology
• Basic understanding of Medicare and Medicaid health plans
• Experience working with Medicare and Medicaid populations
• Ability to comprehend and retain detailed information

Telecommuting Requirements:

• 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 up 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

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable.