Per Diem Nurse Practitioner
4 weeks ago
Primary Responsibilities:
Primary Care Delivery
Deliver cost-effective, quality care to assigned members
Manage both medical and behavioral, chronic and acute conditions effectively, and in collaboration with a physician or specialty provider
Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations
Responsible for ensuring that all diagnoses are ICD10, coded accurately, and documented appropriately to support the diagnosis at that visit
The APC is responsible for ensuring that all quality elements are addressed and documented
The APC will do an initial medication review, annual medication review and a post-hospitalization medication reconciliation
Facilitate agreement and implementation of the member’s plan of care by engaging the facility staff, families/responsible parties, primary and specialty care physicians
Evaluate the effectiveness, necessity and efficiency of the plan, making revisions as needed
Utilizes practice guidelines and protocols established by CCM
Must attend and complete all mandatory educational and LearnSource training requirements
Travel between care sites mandatory
Care Coordination
Understand the Payer/Plan benefits, CCM associate policies, procedures and articulate them effectively to providers, members and key decision-makers
Assess the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate team members
Coordinate care as members transition through different levels of care and care settings
Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change
Review orders and interventions for appropriateness and response to treatment to identify most effective plan of care that aligns with the member’s needs and wishes
Evaluate plan of care for cost effectiveness while meeting the needs of members, families and providers to decreases high costs, poor outcomes and unnecessary hospitalizations
Program Enhancement Expected Behaviors
Regular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, CCM staff and other provider groups
Actively promote the CCM program in assigned facilities by partnering with key stakeholders (i e : internal sales function, provider relations, facility leader) to maintain and develop membership growth
Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues
Function independently and responsibly with minimal need for supervision
Ability to enter available hours into web-based application, at least one month prior to available work time
Demonstrate initiative in achieving individual, team, and organizational goals and objectives
Participate in CCM quality initiatives ???
Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling ??
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:
Certified Nurse Practitioner through a national board
For NPs: Graduate of an accredited master’s degree in Nursing (MSN) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP
Active and unrestricted license in the state which you reside
Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Ability to lift a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations
Availability to work 24 hours per month, with expectations that 16 of the 24 hours/month could be during off-hours (after 5 pm, on weekends, and/or holidays) not to exceed 960 hours in a calendar year
Ability to gain a collaborative practice agreement, if applicable in your state
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