Advanced Practice Clinician

6 days ago


Portsmouth, New Hampshire, United States Optum Full time

Optum is at the forefront of transforming healthcare. As a member of our Senior Community Care team, you will play a pivotal role in delivering high-quality care to patients in their homes, nursing facilities, or assisted living settings.

We are dedicated to creating seamless health journeys for our patients across various care settings. Join us as we pioneer innovative approaches to care coordination, ensuring that every patient receives comprehensive support whenever and wherever they need it.

The Advanced Practice Clinician (APC) role involves working closely with patients, families, and caregivers to develop personalized care plans that address their unique needs and circumstances. This may involve assessing medical necessity, facilitating transitions between care settings, and coordinating services to promote optimal health outcomes.

Key Responsibilities:

  • Care Delivery
    • Deliver cost-effective, quality care to assigned members by managing 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 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.
    • Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues.

**Requirements:

  • Active national NP or PA certification or the ability to obtain national certification in state of assignment by start date.
  • Active and unrestricted APC license in the State of New Hampshire.
  • 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.

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.
  • Ability to develop and maintain positive customer relationships.


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