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.

One of five regions in the Optum nationwide network, Optum Tri-State comprises three large multispecialty groups, CareMount Medical, ProHEALTH NY, Riverside Medical Group, and Crystal Run. Optum Tri-State brings patients local care, backed by national expertise. As a premier provider of health care services, Optum Tri-State offers services including primary care, urgent care, a diverse range of specialty care, outpatient surgery, and imaging. The regions draws on the knowledge of leading doctors and healthcare experts to help 1.6 million patients across 630 locations access high quality, affordable healthcare within their community.

Optum’s Tri-State Value Business aims to improve the experience of care, improve the health of populations, and reduce the total cost of care. The Value Business is responsible for the performance of Medicare global capitation contracts for two risk entities: OptumCare Network of New Jersey (OCN NJ), Optum IPA of New York (ONY) and OptumCare Network of Connecticut. CareMount, ProHEALTH, Riverside, and Crystal Run physicians participate in and contribute patients to these risk entities, and the Value Business innovates, coordinates, and delivers programs to achieve positive clinical and financial outcomes. Additionally, the Value Business is responsible for commercial quality incentive contracts that reside with these groups. Achieving success in value-based programs requires engagement and strategic alignment across the entire Tri-State organization, and clinical operations, physician leadership, finance, and our other Tri-State teams collaborate to ensure patients are receiving high-quality, coordinated care.

The Medication Navigator is responsible for outreaching to and engaging with patients around adhering to medications. The Medication Navigator supports patient experience and clinical outcomes by ensuring patients are able to fill, refill, and take medications as prescribed by their provider. The Medication Navigator will help to identify barriers to adhering to medications and assist patients with navigating and overcoming challenges related to adherence. The Medication Navigator is a key contributor to the Quality Team by supporting strong performance against priority quality and patient experience measures.

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

Primary Responsibilities:

The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment.

• Engage with patients, providers, and pharmacies to promote the timely fill or re-fill of medications, especially those that are routinely prescribed to manage cholesterol, hypertension, and diabetes

• Educate and empower patients to understand their prescribed medication regimen and its benefits

• Serves as subject matter expert on pharmacy related measures, including but not limited to: MAD, MAC, MAH, SUPD, SPC

• Assists in the resolution of issues and elimination of roadblocks to ensure patients are positioned to fill or re-fill medications. Connect patients with resources to reduce cost, access mail delivery, and obtain 90 to 100-day refills. Serves as an escalation point for non-clinical staff members

• Complete minimum daily goals for outreach (telephonic, mail) to patients, providers, and pharmacies

• Review, audit, and report discrepancies around medication adherence reporting from payors

• Participate in meetings with Tri-State Leadership and payors to discuss innovative strategies and tactics for improving medication adherence

• Aides in the development of new programs and workflow evolution, such as management of high risk patients

• Supports measure performance activities including chart review, abstraction, and submission to payors

• Mentors and trains non-clinical staff

• Performs other duties as assigned

Knowledge, Skills & Abilities:

Note that these requirements are representative, but not all-inclusive, of the knowledge, skill, and ability required to perform this job

• Knowledge: Exceptional knowledge and experience in working with patients around medication management, reconciliation, or adherence. Strong understanding of how medications for chronic conditions including high cholesterol, hypertension, and diabetes are routinely prescribed and refilled. Knowledge of information systems and healthcare applications, including EMRs. Continued commitment to learning and staying recent on medication adherence measure specifications and clinical guidance

• Skills: Strong interpersonal skills and an understanding of and commitment to patient-centered medical care with a team-based approach. Strong telephonic skills and a demonstrated ability to maintain accurate notes and records. Ability to work independently, exercise creativity, and is detail-oriented. Proficiency in the use of Microsoft Office applications: Word, Excel, and Outlook and the ability to learn and apply new technologies and skills

• Abilities: Exceptional communication and customer service skills. Ability to manage multiple and simultaneous responsibilities

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 (or higher)

• 2+ years of experience working with patients, preferably with experience supporting medication reconciliation or management

• Basic level of proficiency in the use of Microsoft Office applications: Word, Excel, and Outlook and the ability to learn and apply new technologies and skills

• Ability to work Monday – Friday, 8:30am – 5pm EST

Preferred Qualifications:

• Associate’s degree or higher in pharmacy or nursing is preferred

• Certification as a Pharmacy Technician, Medical Assistant, or Nurse is preferred

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

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Washington, or Washington D.C Residents Only : The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Washington, or Washington D.C residents is $16.54 to $32.55 per hour. 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.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

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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