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Nurse Practitioner or Physician Assistant

2 months ago

Wethersfield, Connecticut, United States Optum Full time
Optum Home and Community Care - A New Era in Healthcare

We are creating something new in healthcare at Optum Home and Community Care, part of the UnitedHealth Group family of businesses. Our integrated care model addresses an individual's physical, mental, and social needs, providing seamless access to care anytime and anywhere.

Our Mission

We are committed to delivering cost-effective, quality care to our members, managing both medical and behavioral, chronic and acute conditions effectively. Our team of Nurse Practitioners and Physician Assistants work collaboratively with physicians and specialty providers to ensure comprehensive assessments and documentation that meet CMS regulations.

Key Responsibilities
  • Primary Care Delivery
    • Deliver high-quality care to assigned members, ensuring their medical and behavioral needs are met.
    • Manage chronic and acute conditions, collaborating with physicians and specialty providers as needed.
    • Perform comprehensive assessments, documenting findings in a concise and compliant manner.
    • Ensure accurate ICD10 coding and documentation to support diagnoses.
    • Address quality elements and document accordingly.
    • Conduct initial medication reviews, annual medication reviews, and post-hospitalization medication reconciliations.
    • Facilitate agreement and implementation of the member's plan of care, engaging facility staff, families, and primary and specialty care physicians.
    • Evaluate the effectiveness, necessity, and efficiency of the plan, making revisions as needed.
    • Utilize practice guidelines and protocols established by CCM.
  • Care Coordination
    • Understand Payer/Plan benefits, CCM associate policies, and articulate them effectively to providers, members, and key decision-makers.
    • Assess medical necessity and effectiveness of ancillary services, determining the appropriate initiation of benefit events and communicating the process to providers and team members.
    • Coordinate care as members transition through different levels of care and care settings.
    • Monitor member needs and facilitate adjustments to the plan of care as situations and conditions change.
    • Review orders and interventions for appropriateness and response to treatment, identifying the most effective plan of care that aligns with member needs and wishes.
    • Evaluate the plan of care for cost-effectiveness, meeting member, family, and provider needs while decreasing 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, partnering with key stakeholders to maintain and develop membership growth.
    • Exhibit original thinking and creativity in developing 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 applications, 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 of Connecticut.
  • 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.
  • Adaptability to change.

At Optum, we are committed to creating a healthier atmosphere for everyone. We believe that diversity and inclusion are essential to our mission and values. We are 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.