Nurse Practitioner or Physician Assistant

2 weeks ago

Cromwell, Connecticut, United States Optum Full time
Optum Home & Community Care: A Leader in Integrated Care

At Optum Home & Community Care, we're revolutionizing the way healthcare is delivered. Our team is dedicated to providing comprehensive care to patients in the comfort of their own homes, nursing homes, and assisted living facilities. As a Nurse Practitioner or Physician Assistant, you'll play a vital role in our mission to improve access to care and enhance the overall health and well-being of our patients.

Key Responsibilities:
  • Primary Care Delivery:
    • Deliver high-quality, cost-effective care to assigned members
    • Manage medical and behavioral, chronic and acute conditions effectively, in collaboration with physicians or specialty providers
    • Perform comprehensive assessments and document findings in a concise and compliant manner
    • Ensure accurate and appropriate coding and documentation of diagnoses and treatments
    • Facilitate agreement and implementation of the member's plan of care by engaging facility staff, families, 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
    • Attend and complete all mandatory educational and training requirements
    • Travel between care sites is mandatory
  • 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 to determine the appropriate initiation of benefit events and communicate the process to providers and team members
    • Coordinate care as members transition through different levels of care and care settings
    • Monitor the needs of members and families while facilitating 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 to maintain and develop membership growth
    • Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns and issues
    • Function independently and responsibly with minimal need for supervision
    • Ability to enter available hours into a 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

Required Qualifications:
  • Certified Nurse Practitioner through a national board
  • Active and unrestricted license in the state of residence
  • 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 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 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

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