Nurse Practitioner/Physician Assistant

4 weeks ago


Everett, Massachusetts, United States Optum Full time
Optum Home & Community Care Opportunity

Optum Home & Community Care is seeking a highly skilled Nurse Practitioner/Physician Assistant to join our team. As a member of our Senior Community Care (SCC) product, you will work with a team to provide care to patients at home, in nursing homes, assisted living facilities, and senior housing. This life-changing work adds a layer of support to improve access to care.

We're connecting care to create a seamless health journey for patients across care settings. You will be responsible for delivering cost-effective, quality care to assigned members, managing both medical and behavioral, chronic and acute conditions effectively, and in collaboration with a physician or specialty provider. You will also 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.

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
  • 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
  • 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 to maintain and develop membership growth

Requirements:
  • For NPs - Certified Nurse Practitioner through a national board
  • For PAs - Certified Physician Assistant through a national board
  • Active and unrestricted license in the state in 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 a 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


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