Nurse Practitioner Home Visits Specialist

2 weeks ago

Denver, Colorado, United States Optum Full time
Optum Home-Based Medical Care Job Opportunity

We are seeking a skilled Nurse Practitioner to join our Home-Based Medical Care team in Adams County, CO. As a member of our integrated medical teams, you will play a critical role in delivering high-quality, patient-centered care to complex, chronic patients in their homes.

Key Responsibilities:

  • Provide comprehensive medical care and management to members served by the program
  • Participate in gathering clinical information for medical necessity determinations for service requests
  • Collaborate with the Landmark Health Medical Director, Director of Health Services, and UM staff in the development and implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs
  • Establish and maintain effective relationships with members, facility staff, PCPs, and other collaborating physicians/providers
  • Perform initial comprehensive assessments, develop member management care plans, and update them as needed
  • Prescribe appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissions
  • Consult with hospital physicians following notification of member transfer
  • Collaborate with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
  • Educate members and/or their legal representatives in disease processes affecting members and ways to manage them effectively
  • Provide counsel, support, and education to facility staff
  • Support FCMs in developing and providing in-service educational programs to facility staff

Requirements:

  • Completion of Nurse Practitioner accredited program
  • Current state RN license
  • Current NP license
  • Knowledge of long-term care, community resources, and cost-effective alternatives regarding patient care delivery systems
  • Knowledge of CPT, ICD-9, and HCPC codes
  • Knowledge of clinical standards of care
  • Computer skills, including proficiency in Windows 2000 and MS Office Word Processing software

Preferred Qualifications:

  • 2+ years of clinical experience
  • Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems

Work Environment:

The noise level in the work environment is usually moderate.

Colorado Residents Only:

The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors, including local labor markets, education, work experience, certifications, and more. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).

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