Quality and Pa Specialist

7 days ago

Buffalo, New York, United States Optum Full time
Job Title: Quality and Pa Specialist

Optum Home and Community Care is seeking a Quality and Pa Specialist to join our team. As a Quality and Pa Specialist, you will be responsible for providing high-quality care to our patients in their homes and communities.

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
Requirements:
  • 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
  • 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)
  • Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
  • 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
What We Offer:
  • A comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution

At Optum, our mission is to help people live healthier lives and make the health system work better for everyone. 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.

OptumCare 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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