Care Advocate – Remote in Houston, TX

If you are located within 4700 W Sam Houston Pkwy North, Houston, TX 77041, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

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.

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.

Must live in a commutable distance to the office – will be asked to come onsite for team meetings (3-4 times per year) – if you have connectivity issues -you come onsite to work

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 8am – 5pm  CST. It may be necessary, given the business need, to work occasional overtime.

We offer 3-4 weeks of paid training. The hours during training will be 8am – 5pm  CST, Monday – Friday

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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
• 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) Job Title: Care Advocate II Job Code: MCO102 (Grade 24) Organization: WellMed WellMed Medical Group Comfort Care Department: Care Management Reports To: Manager, Care Management FLSA Status: Non-Exempt The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.
• 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.

Required Qualifications:

• High School Diploma / GED
• Must be 18 years of age or older
• 4+ years of experience in customer service support and/or engagement
• Verbal and written skills
• Ability to interact productively with individuals and with multidisciplinary teams
• Organizational and prioritization skills
• Proficient computer skills, including Microsoft Word, Microsoft Excel, Microsoft Access and Microsoft Outlook
• Call Center experience
• Fast pace environment
• Must have the ability to reliably travel locally where/when necessary 
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8am – 5pm  CST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Health care experience
• Bilingual fluency in English and Spanish
• 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:

• Reside within 4700 W Sam Houston Pkwy North, Houston, TX 77041
• 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 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

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.

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.

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