Nurse Practitioner

4 weeks ago

Midlothian, Virginia, United States Optum Full time
Optum Home & Community Care: A Leader in Integrated Care

We are creating something new in healthcare at Optum Home & Community Care, part of the UnitedHealth Group family of businesses. Our goal is to build an integrated care model that addresses an individual's physical, mental, and social needs, helping patients access and navigate care anytime and anywhere.

Job Summary

We are seeking a skilled Nurse Practitioner to join our Senior Community Care (SCC) product team. As a key member of our team, you will provide care to patients at home, in nursing homes, assisted living facilities, and senior housing. Your expertise will add a layer of support to improve access to care and create a seamless health journey for patients across care settings.

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
    • The APC is responsible for ensuring that all quality elements are addressed and documented
    • The APC will do an initial medication review, annual medication review, and a post-hospitalization medication reconciliation
    • Facilitate agreement and implementation of the member'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 is mandatory
  • 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
    • Coordinate care as members transition through different levels of care and care settings
    • Monitor the needs of members 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 the most effective plan of care that aligns with the member's needs and wishes
    • Evaluate the plan of care for cost-effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes, and unnecessary hospitalizations
  • 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 (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 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)
  • 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
  • Available 10 hours per week during the hours of 8 am to 5 pm, Monday through Friday
  • 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

We offer a superior professional environment and incredible opportunities to make a difference in the lives of patients. As an employer of choice, we are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes. 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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