Care facilitator (pride + care program)

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 Pride+ and HIV Care Facilitator, as a member of a Pride+ Care Adult primary healthcare team, facilitates the process of care for Reliant Medical Group’s LGBTQIA+ Adult Primary Care patients, coordinates an accessible plan of care and assess for clinical triggers. They will serve as a liaison among the primary care team, specialist physicians, behavioral health team members, care management social workers, and the patient and/or patient’s family. This role will also support patients living with HIV (regardless of identity) as HIV Care provided at Reliant becomes more established.

The Care Facilitator is a critical team member in creating an exceptional patient experience. Vital to this role is forming longitudinal relationships with LGBTQIA+ patients, regularly assessing their clinical or social needs, and coordinating with primary care, case management, and social work teams to refer patients to community support services, aligned with their LGBTQIA+ identity and values. As part of forming longitudinal relationships, the facilitator is expected to maintain an understanding of the patient’s identity, pronouns, preferred language and cultural beliefs and values which impact care, patient experience or recommended treatment plan.

The person in this role will also provide data management of the LGBTQIA+ patient population, and conduct patient outreach for follow-ups, referrals, and specialized care needs. The Care Facilitator populates standardized clinical and social information in the administrative areas of the care plan in the patient’s medical record, and collects data, and generates reports. Ensures clinicians are informed of assigned patients’ status and may present performance metrics to larger group of clinicians. Attends required specialty meetings and participates in care improvement activities as needed to improve quality performance. These activities include, but are not limited to, ongoing training for the care team and front office staff.

Location: Onsite role in Worcester (5 Neponset St.) or Leominster, MA (225 New Lancaster Rd.). Role will require up to 25% between sites and within the community (and MA) for events.

Schedule: Monday-Friday, between the hours of 8am-6pm EST. Schedule to be determined by supervisor upon hire.

Primary Responsibilities:

• Serves as a primary point of contact for LGBTQIA+ patients, providing them with tailored support and guidance throughout their healthcare journey
• Advocates for patients' needs and rights within the healthcare system, helping to address challenges or barriers to care
• Collaborates with primary care case management, internal and external specialists, nutrition, social work and insurers as needed
• Tracks patient adherence with scheduled appointments, labs, studies, referrals, and prescription compliance
• Manages program referral work queue and supports patients in scheduling primary care and Pride+ specific appointments
• Independently contacts patients, clinical and administrative staff, and external organizations to gather and relay clinical and care plan information
• Performs high volume of daily patient outreach calls, mailings and MyHealth messages in regard to lab tests, appointments and other chronic care recommendations made by the primary care team
• Regularly assesses at risk patients for clinical triggers that could require clinical intervention
• Documents details of outreach attempts into patients’ electronic medical record to ensure Coordination of care
• Guides patient through process of care including transitions, providing directions, identifying barriers and approaches, serving as advocate and facilitator to enable specialty care needs
• Supports communication with clinicians and validates patient understanding
• Actively collects feedback on the LGBTQIA+ Adult Medicine program and makes recommendations for continuous improvement
• Supports the maintenance of collaborative relationships with LGBTQIA+ community organizations, advocacy groups, and other stakeholders
• Coordinates and leads monthly pilot panel roster reviews, chronic conditions, and specialty needs
• Attends required meetings related to care navigation, organizational updates, and Pride+ Care specific meetings to facilitate learning and collaboration
• Participates in community events, workshops, and e-Learnings to promote the clinics and raise awareness about LGBTQIA+ health issues
• Supports patients in enrolling in medication assistance programs (e.g., Massachusetts’ HIV Drug Assistance Program [HDAP]), including liaising between patient, care team, and external program(s)
• Assists patients in understanding insurance coverage for primary care and Pride+ specific services, such as gender-affirming care and injectable PrEP or HIV medication
• Supports patients in navigating gender-affirming care landscape, including but not limited to: identifying appropriate gender-affirming surgeons based on patient and insurance needs, liaising between organizations to support care coordination and external referrals, and facilitating prior authorizations for some procedures
• Performs other duties as assigned

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• 1+ years of experience working within a healthcare organization directly with patients

Preferred Qualifications:

• College degree in social work or population health management strongly preferred
• 1+ years of EMR experience
• Experience with referrals
• Previous training or experience in population health management
• Experience working with the LGBTQIA+ community in a facilitator or coordinator capacity and/or exposure to the local LGBTQIA+ ecosystem

Soft Skills:

• Proficiency in data management
• Knowledge of medical terminology
• Strong interpersonal and communication skills with the ability to interact effectively with patients and medical professionals
• Ability to demonstrate a high level of cultural competence and sensitivity to patient needs and concerns
• Problem-solving skills
• Self-starter

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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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