Consumer and Employment Advocate - Massachusetts, Rhode Island, New Hampshire

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. This is an opportunity to advocate for individuals in the position of Consumer & Employment Advocate, an internal and external facing role. As a Consumer Advocate, you will ensure resolution of complex member issues, including investigation, resolution, and communication regarding escalated state cases and My Ombudsman referrals. As an Employment Advocate, you will support One Care members in seeking employment and educational opportunities. As a part of the Advocacy team, you will work collaboratively to support efforts in eliciting and responding to member and caregiver feedback via surveys, focus groups, and/or consumer advisory meetings. You will also evaluate and analyze member satisfaction metrics/data through internal committees and workgroups and participate in developing action plans to increase member satisfaction. This position supports two products at the Massachusetts health plan: UHC One Care (HMO-DSNP) that serves individuals between the ages of 21 and 64 who have physical and intellectual disabilities UHC Senior Care Options (SCO) Plan (HMO Special Needs Plan - SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater If you reside within Massachusetts, New Hampshire, or Rhode Island, you will enjoy the flexibility to telecommute. Primary Responsibilities Consumer Advocate Primary Responsibilities Supports resolution of complex member inquiries while educating members/caregivers about their rights within health plan benefits Analyzes, investigates, and resolves member inquiries; My Ombudsman issues requiring coordination with members, providers, sister segments, and internal departments (such as clinical services, provider relations, and quality) as well as state regulator; may support State Board of Hearing appeals Assesses, anticipates, and interprets enrollee needs and requirements; identifies solutions to non‑standard requests and problems and participates in process improvement activities as a response to feedback Develops relationships and collaborates with internal and external stakeholders (e.g., clinical teams, A&G, Call center, sister segments) to identify their needs and ensure proper delivery of our services/solutions, as needed Participates in efforts focused on medical, behavioral, and social determinants of health factors that improve the well‑being of members and enhance member satisfaction Supports Advocacy team member engagement activities (e.g., Consumer Advisory Committee, surveys, focus groups, town halls) to elicit feedback to the health plan Provides mutual coverage and support to SCO plan Consumer Advocate Employment/Education Advocate Primary Responsibilities Works with members (with complex physical, intellectual disabilities, behavioral health diagnoses and/or SUD) on short‑term interventions who are experiencing a variety of employment issues—including needing assistance with resumes, access to job skills training programs, and support in self‑advocacy goals Provides members with resources, interventions, and support in the community to find, preserve, maintain employment and address volunteerism and educational needs Provides leadership, guidance and expertise as consultant to plan staff clinical teams regarding topics including searching for employment, disability rights laws, reasonable accommodation, right to self‑determination, etc. Builds, strengthens, and fosters strategic connections (including referral pathways) with key community partners throughout the region, focusing on those that work with, employ, or connect low‑income individuals and individuals with disabilities with employment and educational opportunities Recommends and works with clinical teams to refer members to other community supports (e.g., childcare, educational, mental health, substance abuse, domestic violence, legal and family services) that may support the member’s goals Overall Responsibilities Maintains responsive and respectful communication with staff, members, families, and community partners Uses basic counseling skills of active listening, empathy, reflection, and validation; acts as an advocate to help members identify and pursue their identified goals Uses recovery‑oriented, person‑centered, culturally competent, and strengths‑based approaches to help members identify options Documents work within electronic member record 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. Required Qualifications 2+ years of experience working with individuals with BH/SUD diagnoses 1+ years of experience working with Medicaid programs Intermediate level of proficiency in Microsoft Office (Word, Excel, PowerPoint) Willingness and ability to travel up to 10% within Massachusetts for member engagement activities Preferred Qualifications Professionally licensed clinician (e.g., LSW, LCSW, LICSW, LMHC) in MA Bilingual Experience working with Massachusetts Medicaid/Medicare programs Proven track record of building and maintaining community‑based relationships Commitment to diversity, equity and inclusion Presentation skills and ability to speak in front of diverse audiences and facilitate a meeting All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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). The salary for this role will range from $72,800 to $130,000 annually 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. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes. 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. #J-18808-Ljbffr Texas Health Institute