Social Worker, Quality Operations Call Center - Remote

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical Performance Quality (CPQ) Clinical Programs Operations team supports Optum's Care Delivery Organizations by delivering patient-centered, clinically collaborative telephonic outreach to help people live healthier lives. Our team focuses on the design, execution, and delivery of telephonic and digital engagement strategies designed to close Medicare STARS/HEDIS gaps in care, including medication adherence, care for older adults, medication reconciliation post discharge, A1c, Blood pressure and statin therapy in patient with diabetes and cardiovascular disease. Our interdisciplinary service delivery team is comprised of Pharmacists, Registered Nurses, Pharmacy Technicians, and Care Coordinators.

The Social Worker will report into the Manager of Clinical Programs. The Social Worker will perform telephonic, patient-centered outreach focused on addressing Social Determinants of Health (SDoH) and act as a liaison to assist in coordinating resources to the care and health of members. The primary scope is to provide assistance to patients/members and their families as requested with SDOH, personal, ethical, and environmental difficulties to enhance quality of life. The Clinical Programs Social Worker acts as an advocate for members and their families, linking them to community resources and financial assistance programs for continued growth toward a maximum level of independence. The Social Worker will be required to meet or exceed established productivity and quality metrics and work a flexible schedule to support the hours of operation of the business.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Required hours are Monday-Friday 9am-6pm Central Time.

Primary Responsibilities:

• Conduct telephonic outreach that meet/exceed quality metrics and meet or exceed production targets established for these outreaches
• Meet and/or exceed department standards for member outreach turnaround times
• Perform comprehensive assessments and document findings in a concise and comprehensive manner that is compliant with department documentation requirements
• Provide members/patients with internal and external resources and support to improve Social Determinants of Health, non-medical needs and quality measures. (Pharmacy assistance programs, meals on wheels, LIS)
• Coordinates outpatient needs related to community resources, financial assistance programs, and long-term activity of daily living needs outside the benefit criteria of the medical insurance coverage
• Collaborates with market Social Workers, members, PCP's and specialists as needed and provides related feedback on planned interventions and outcomes of plan of care
• Identifies and assists patients/members with SDOH, high-risk diagnoses and/or multiple co-morbidities who will benefit from social care coordination, contracts, providers, and facilities
• Along with the care team, reviews the need for, and assists with obtaining DME, home health and other resources necessary for the patient. Provides patients/members with education about community resources and options and advocates on behalf of the patient
• Takes ownership of the total work process and provides constructive information to minimize problems and increase internal and external customer satisfaction
• Assist with provider outreach for notification of gaps in care and requesting medical records
• Assists in the growth and development of self and associates by sharing special knowledge with others
• 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:

• Bachelors in Social Work (BSW) from an accredited program
• Hold active, unrestricted Compact Licensed Social Worker (LBSW) in the state of work performing
• Currently have or be able to obtain additional LBSW licensure in one or more of the following states: New York, South Carolina, Illinois, New Mexico, Nevada, California, Oregon, Idaho, Utah, Michigan, Pennsylvania or Massachusetts
• 2+ years of experience actively working as a social worker
• 2+ years of clinical background with broad range of experience in health care delivery setting (hospital, clinic, physician's office, community work)
• 2+ years of experience in patient or member facing roles
• Experience of experience with Social Determinates of Health (SDoH) and addressing associated barriers
• Proficient in PC software computer skills such as Microsoft Word, Excel, Power Point, Outlook

Preferred Qualifications:

• Graduate of an accredited Master's degree Social Work Program
• Current and unrestricted LBSW license in one or more of the following states: New York, South Carolina, Illinois, New Mexico, Nevada, California, Oregon, Idaho, Utah, Michigan, Pennsylvania or Massachusetts
• Active/unrestricted licensed Masters in Social Work (LMSW)
• Experience working with geriatric patient populations
• Call Center or Telephonic Outreach experience
• Knowledge of STARs and HEDIS measures, managed care, medical terminology, referral process
• Bilingual preferred with preference given to Spanish and Vietnamese

Competencies:

• Excellent written and verbal communication and relationship building skills
• Ability to effectively and efficiently transition to multiple assignments
• Ability to manage multiple complex, concurrent projects
• Independent problem identification/resolution and decision making skills
• Ability to work independently as well as a member of a team
• Ability to work effectively in a fast-paced call center environment

Physical & Mental Requirements:

• Ability to lift up to 10 pounds
• Ability to sit for extended periods of time
• 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 $23.70 to $46.35 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.