Care Coordinator
3 weeks ago
Optum, part of the UnitedHealth Group, is pioneering a new model of care that addresses an individual's physical, mental and social needs.
About This RoleWe're seeking a Senior Community Care Nurse Practitioner/Physician Assistant to provide medical services to Optum members on a periodic or intermittent basis. As a key member of our care team, you'll be responsible for delivering high-quality, cost-effective care to our patients while ensuring compliance with regulatory requirements.
Key Responsibilities:- Primary Care Delivery
- Deliver comprehensive medical care to assigned members, focusing on effective management of chronic and acute conditions in collaboration with physicians and specialty providers.
- Conduct thorough assessments, documenting findings accurately and in compliance with CMS regulations.
- Ensure accurate ICD10 coding and documentation to support diagnoses.
- Foster collaboration between healthcare providers, families, and facility staff to develop and implement personalized care plans.
- Evaluate plan effectiveness, making revisions as needed to ensure optimal outcomes.
- Utilize established protocols and guidelines to inform care decisions.
- Care Coordination
- Develop a deep understanding of Payer/Plan benefits, CCM policies, and procedures to effectively communicate with providers, members, and key stakeholders.
- Assess medical necessity and coordinate care transitions between levels of care and settings.
- Monitor member needs, facilitating adjustments to care plans as circumstances change.
- Evaluate plan effectiveness in reducing costs, improving outcomes, and preventing unnecessary hospitalizations.
- Program Enhancement Expected Behaviors
- Maintain regular communication with internal and external parties, including physicians, members, and facility leaders.
- Promote the CCM program through partnerships with key stakeholders to drive membership growth.
- Demonstrate creativity and initiative in developing new approaches to address concerns and issues.
- Work independently with minimal supervision, utilizing strong problem-solving skills.
- Stay up-to-date with training and communications, adapting to changing priorities and objectives.
This role requires a strong foundation in nursing practice, excellent communication skills, and the ability to work collaboratively within a dynamic team environment. If you're passionate about delivering high-quality patient care and driving innovative solutions, we encourage you to apply.
Requirements:- Certified Nurse Practitioner or Physician Assistant through a national board.
- Active, unrestricted license in the state where you reside.
- Current DEA licensure/prescriptive authority, or ability to obtain post-hire (per state regulations).
- Reliable transportation for traveling to client and/or patient sites within designated areas.
- Able to lift 30-pound bags and navigate various dwelling conditions and configurations.
- Availability to work 24 hours/month, with a minimum of 16 hours during off-hours (after 5 pm, weekends, and holidays), not exceeding 960 hours/year.
- 1+ years of hands-on experience in Long Term Care.
- Strong understanding of Geriatrics and Chronic Illness.
- Ability to develop and maintain positive customer relationships.
- Proficient computer skills, including electronic medical records.
New York Residents: The estimated hourly range for this role is $52.65 to $76.92 per hour.
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