Medical Care Specialist

4 weeks ago

South Windsor, Connecticut, United States Optum Full time

Optum Home & Community Care is a leading provider of home health care services, and we are seeking a skilled Nurse Practitioner or Physician Assistant to join our team.

As a member of our Senior Community Care (SCC) product, you will work with a team to provide high-quality care to patients in their homes, nursing homes, and assisted living facilities. Our goal is to improve access to care and enhance the overall health and well-being of our patients.

Key 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:

  • Certified Nurse Practitioner 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 the state of practice)
  • Ability to lift a 30-pound bag in and out of a car and navigate stairs and a variety of dwelling conditions and configurations
  • Available 10 hours per week during the hours of 8 am to 5 pm, Monday through Friday

Preferred Qualifications:

  • 1+ years of hands-on post-grad experience within Long Term Care
  • Understanding of Geriatrics and Chronic Illness
  • Understanding of Advanced Illness and end-of-life discussions
  • Proficient computer skills, including the ability to document medical information with written and electronic medical records

At Optum, we are committed to creating a healthier atmosphere and promoting diversity, equity, and inclusion in all aspects of our business.

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.

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