Advanced Practice Registered Nurse

1 week ago

Midlothian, Virginia, United States Optum Full time
About the Role

Optum, a leading health services organization, is seeking a highly skilled Advanced Practice Registered Nurse (APRN) to join our team. As a key member of our Senior Community Care (SCC) product, you will play a vital role in providing high-quality, patient-centered care to individuals in their homes, nursing homes, and assisted living facilities.

Key Responsibilities
  • Primary Care Delivery
    • Deliver cost-effective, quality care to assigned patients
    • 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 APRN is responsible for ensuring that all quality elements are addressed and documented
    • The APRN will do an initial medication review, annual medication review and a post-hospitalization medication reconciliation
    • Facilitate agreement and implementation of the patient'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, patients 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 patients transition through different levels of care and care settings
    • Monitor the needs of patients 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 patient's needs and wishes
    • Evaluate plan of care for cost effectiveness while meeting the needs of patients, 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, patients, 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
Requirements
  • Certified Nurse Practitioner through a national board
  • 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)
  • Ability to lift a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations
  • Available 10 hrs per week during the hours of 8 am to 5 pm M-F
  • Ability to gain a collaborative practice agreement, if applicable in your state
  • Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
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
  • Proven ability to develop and maintain positive customer relationships
  • Proven adaptability to change

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