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 overall purpose of the Field Care Advocate (FCA) role is to help individuals live their lives to the fullest by promoting recovery and resiliency via coordination and collaboration with multiple internal and external partners including consumers and their families/caregivers, medical, behavioral health, and clinical network teams.
Field Care Advocates work with complex and high-risk needs with a goal of engaging the consumer in the treatment process, decreasing their reliance on higher levels of care, helping them to access appropriate community services, and assisting them in improving community tenure. FCAs work to increase stabilization and help consumers to improve life satisfaction.
If you are located in Kona, HI, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- Utilize advanced clinical skills to engage and motivate Consumers via a recovery, health, and wellness-oriented approach
- Assist consumers and their families/caregivers with connections to appropriate psychiatric, medical, and psychosocial referrals and services
- Identify and remove barriers to procurement, delivery, participation in and success of services
- Provide supportive follow-up, monitoring and education as indicated
- Meet with consumers in-person at facilities, provider offices, and in homes as appropriate for market
- Serve as OBHS liaison and subject matter expert for applicable UnitedHealth Care Medical Partners; establish and foster positive relationships with medical team, participate in medical-behavioral integration activities and discussions
- Identify high-risk, co-morbid needs of consumers
- Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary psychiatric and community referrals as needed
- Contribute to treatment plan discussions; routinely attend clinical rounds and other meetings with medical partner or external entities when applicable
- Partner with internal Optum Behavioral Health Services Teams to coordinate a seamless transition for consumers from an inpatient setting to community-based services
- Coordinate with teams early in admission on cases stratified as having complex and high-risk needs
- Participate jointly in rounds, discussions, supervision and staffing
- Assist in the development of a relevant and consumer-specific aftercare plan
- Comply with all policies, procedures, and documentation standards in appropriate systems, tracking mechanisms and databases
- For specific markets, conduct focused facility-based or outpatient clinical utilization review activities
- Provide face-to-face outreach to members admitted to an acute IP facility near the time of and throughout admission and then on the day of discharge to ensure adequate OP follow-up after hospitalization. Continue follow-up with members after discharge to reinforce follow-up with outpatient BH providers, PCPs and other specialists as needed
- Establish a cooperative relationship with Optum Behavioral Network Services and the Provider community to improve access to services and ensure that consumers are served within proper standards of care
- Identify new programs, services, and gaps in market; share information with network teams
- Maintain knowledge of provider availability and barriers to access
- Collaborate with providers to determine acuity of mental health concerns, barriers and progress; coordinate appropriate services
- Conduct provider networking visits or attend consumer care conferences as determined by market
- Attend state, professional and association and conference call meetings as needed
- Develop and sustain collaborative partnerships with community social service and health care providers which provide support for members within our community
- Provide ongoing clinical and case consultation regarding shared members, and assist with coordinating medical services and support from the health plan
- Partner in providing clinical trainings to support integration of best practices to improve the quality of services received by members in the community
- Actively participate in community events which promote recovery and resiliency efforts and services for members
- Other activities as assigned, including but not limited to:
- Partnership with Account Management and Sales departments to provide best level of customer service to market accounts
- Participate in committees, educational opportunities, and trainings
- Maintain approved workload and support metrics and outcomes
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:
- Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2+ years of experience in behavioral health
- Licenses must be active and unrestricted in the status of Hawaii
- 2+ years of experience in a related mental health environment working in the local community
- Demonstrated ability to use a PC in a Windows environment, including email and Microsoft Office applications
- Proven excellent customer service, interpersonal and problem-solving skills
- Proven solid team player and team building skills
- Proven ability to function independently and responsibly with minimal supervision
- Proven ability to maintain direct and open communication with all levels of the organization
- Proven ability to handle sensitive issues with peer, members, and providers in a confidential manner
- Demonstrate initiative in achieving individual, team, and organizational goals and objectives
- Proven ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
- Proven solid oral and written communication skills - specifically telephone skills
- Current, unrestricted driver’s license in Kona, HI and access to reliable transportation
- Residence in Kona, HI
Preferred Qualifications:
- Medical/Behavioral setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice)
- Dual diagnosis experience with mental health and substance abuse
- Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
- Experience working with low-income populations
- Experience working with the aged, blind or disabled
- Clinical training experience Managed care and utilization management experience
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Hawaii Residents Only: The salary range for this role is $58,300 to $114,300 annually. 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.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
