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Nurse Practitioner

4 weeks ago

Clearfield, United States Optum Full time

Optum Home & Community Care is part of the UnitedHealth Group family of businesses, creating a new model in healthcare.

We unite industry-leading solutions 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.

$5,000 Sign-on Bonus for External Candidates

As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing.

This life-changing work adds a layer of support to improve access to care.

We're connecting care to create a seamless health journey for patients across care settings.

This growth is not only a testament to our model's success but the efforts, care, and commitment of our Nurse Practitioners.

Serving millions of Medicare and Medicaid patients, Optum is the nation's largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family of businesses.

You have found the best place to advance your advanced practice nursing career.

Job Summary:

As a CCM Nurse Practitioner/Physician Assistant per diem, you will provide care to Optum members and be responsible for the delivery of medical care services in a periodic or intermittent basis.

Key Responsibilities:

  • 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
  • Responsible for ensuring that all diagnoses are ICD10, coded accurately, and documented appropriately to support the diagnosis at that visit
  • 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
  • Must attend and complete all mandatory educational and LearnSource training requirements
  • Travel between care sites 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:

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

Ability to enter available hours into a web-based application, at least one month prior to available work time

Participate in CCM quality initiatives

Requirements:

  • Certified Nurse Practitioner through a national board
  • For NPs: Graduate of an accredited master's degree in Nursing (MSN) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP
  • 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 a 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
  • 1+ years of hands-on post-grad experience within Long Term Care
  • Proficient computer skills, including the ability to document medical information with written and electronic medical records

About UnitedHealth Group:

Our mission is to help people live healthier lives and make the health system work better for everyone.

Today, however, there are still far too many barriers to good health, which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere:

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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment Optum.