Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
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.
- 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
- Conduct 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 computer 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
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.
- High School Diploma or GED
- 4+ years of experience in customer service support and/or engagement
- Excellent verbal and written skills
- Proficient computer skills, including Microsoft Word, Excel, Access and Outlook
- Ability to reliably travel locally where/when necessary
- This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease.
- You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
- Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Groupapproved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
- 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
Physical & Mental Requirements:
- Ability to lift up to 10 pounds
- 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
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
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 drugfree workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Care Advocate II, Medicare, Medicaid, Spanish, Jacksonville, Medical Terminology, Customer Service, Healthcare, Health Plan, Fort Myers, FL, Florida