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Registered Nurse Home Health

4 months ago

Allentown PA, United States Optum Full time

40,000 Student Loan Repayment or $20,000 Sign-on Bonus for individuals who have not previously participated in this program.

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.
 

As a team member of our Landmark product, we help bring home-based medical care to complex, chronic patients. This life-changing work helps give older adults more days at home.
 

We’re connecting care to create a seamless health journey for patients across care settings. Provides medical care and management to members served by the program and participates in gathering clinical information for medical necessity determinations for service requests. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs. Dedicated to improving the health and well-being of members, this position collaborates with the PCP, and as needed, the health plan Medical Director and other health professionals, to develop members’ goals of care in all phases of long-term care.

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing
Understands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communities
Establishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providers
Performs an initial comprehensive assessment on all newly enrolled members and bi-annually thereafter. Develops a member management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization. Meets with members and/or their legal representatives to review newly developed or modified care plans; Completes follow-up and post-hospital assessments according to documented standard operating procedure
Consults with hospital physicians following notification of member transfer
Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
Educates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellness
Provides counsel, support and education to facility staff
Supports FCMs in developing and providing in-service educational programs to facility staff
Monthly staff meetings
Quarterly Quality Improvement Committee meetings
Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery
Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
pursues training and development opportunities; responds to requests for service and assistance; takes independent actions and calculated risks; asks for and offers help when needed; 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. 
Knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems
Knowledge of clinical standards of care
if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy

Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems 


Language Skills:
~ Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Computer Skills:
~ To perform this job successfully, an individual should have knowledge of Windows 2000 and MS Office Word Processing software

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
If an employee leaves Home and Community, the student loan repayments will cease. The employee must remain in an Advanced Practice Clinician or Physician role within Home and Community for 36 months to receive the full benefit of the student loan repayments.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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. 

UnitedHealth Group is a drug-free workplace.