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.
This is a field-based position traveling to physician practices. Advocates review charts (paper and electronic - EMR), look for gaps in care, perform STARs assessments, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention. Advocates primarily work at physician practices daily. This position does not entail any direct member care nor does any case management occur. (with the exception of participating in health fairs and/or health screenings where member contact could occur)
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 8:00 am - 5:00 pm.
We offer 4 weeks of training during normal business hours.
Primary Responsibilities:
- Provides care coordination through physician practices for members to improve clinical quality and clinical documentation.
- May conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
- May interact with members via telephone; Schedule appointments, Follow-up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed that relate to preventative health screenings or HEDIS gaps in care
- Review member charts prior to a physician appointment and create alerts/triggers to highlight Star opportunities for the practice.
- Partner with the practice's administrative and clinical staff while managing member appointments and data between visits.
- Create and maintain a professional and supportive relationship with the member, provider and office staff
- Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services
- Assists the member to access community, Medicare, family and other third-party resources as appropriate
- Collaborates and communicates with the member's health care and service with our interdisciplinary delivery team to coordinate the appointments, screening or care related to preventative health screenings or HEDIS gaps in care
- Provides education to members regarding health care needs and available services related to preventative health screenings or HEDIS gaps in care
- Works to facilitate member compliance with their appointments, screenings, medications and/or action plans to complete open care opportunities/HEDIS gaps in care
- Identifies barriers for compliance in preventative health screenings or HEDIS gaps in care and communicates with members and providers to formulate action plan to address
- Documents member conversations and activities in Optum/UHC programs. No documentation in provider EMRs and/or member charts
- Maintains a focus on timely, high-quality customer service
- Maintains the confidentiality of all sensitive information
- Weekly commitment of 75% travel for business meetings (including client/health plan partners and provider meetings) and 25% remote work.
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:
- High School Diploma/GED
- Pharmacy Technician License/Certified
- Must be 18 years of age OR older
- 1+ years of experience as a pharmacy technician
- 1+ years of healthcare telephonic customer service experience
- 1+ year of working experience with Microsoft Tools: Microsoft Word and Microsoft Outlook
- Ability to travel 75% of the time for business meetings (including client/health plan partners and provider meetings) and 25% remote work
- Reside within an hour from Saint Louis, MO
- Ability to work between the hours of 8:00 am - 5:00 pm from Monday - Friday
Preferred Qualifications:
- 1+ year of working experience with ICD- 9/10 and CPT Codes
- Experience with working in a physician, provider, and/OR medical office
- Medical Assistant
- LPN
- EMR and HEDIS knowledge and experience
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. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
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.
OptumCare i s an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.