Nurse Practitioner

1 week ago


media, United States UnitedHealth Group Inc Full time
Nurse Practitioner - Complex Care at Home - Delaware, Southern Philadelphia and Allegheny Counties - PA

$40,000 Student Loan Repayment Or $20,000 Sign-on Bonus For Individuals Who Have Not Previously Participated In This Program Landmark, part of the Optum family of businesses, is seeking a Nurse Practitioner - Complex Care at Home to join our team in Philadelphia County, PA. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. Do you want to make a difference in healthcare? Landmark Health was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are ill-equipped to navigate our overwhelming healthcare system. Because many of our patients are frail and elderly, we deliver care primarily in the comfort of their home. Our Program is also offered to eligible patients at no incremental financial cost to them. We are not a fee-for- service practice; we benefit economically only if we deliver high-quality patient outcomes and satisfaction. As a result, our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve. At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral Health, and other employed team members. Join Landmark to be part of a growing company full of purpose-driven, action-oriented, and compassionate team members working to dramatically transform healthcare for our communities. Provides medical care and management to members served by the program and participates in gathering clinical information for medical necessity determinations for service requests. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs. Dedicated to improving the health and well-being of members, this position collaborates with the PCP, and as needed, the health plan Medical Director and other health professionals, to develop members' goals of care in all phases of long-term care. Primary Responsibilities: * Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing * Understands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communities * Establishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providers * Performs an initial comprehensive assessment on all newly enrolled members and bi-annually thereafter. Develops a member management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization. Meets with members and/or their legal representatives to review newly developed or modified care plans; involves the PCP in these meetings * Completes follow-up and post-hospital assessments according to documented standard operating procedure * Prescribes appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissions * Consults with hospital physicians following notification of member transfer * Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services * Educates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellness * Provides counsel, support and education to facility staff * Supports FCMs in developing and providing in-service educational programs to facility staff * Participates in management meetings that include, but may not be limited to: * Weekly case conference reviews * Monthly staff meetings * Schedule Joint Operating Committee meetings * Quarterly Quality Improvement Committee meetings * Continuing education/journal club programs * Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery * On-call for caseload during business hours. May require some participation in clinical on-call program as plan expands * Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews * Perform related duties as necessary and other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Completion of Nurse Practitioner accredited program * Licensed as NP in state where you will be practicing * Proven knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems * Proven knowledge of CPT, ICD-9 and HCPC codes * Proven knowledge of clinical standards of care * Access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy Preferred Qualifications: * 2+ years clinical experience * Demonstrated awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful PLEASE NOTE Employees must be in an active regular status. Employees must remain in role for a minimum of 12 months from the date of hire /rehire/transfer. If an employee leaves Home and Community, the student loan repayments will cease. The employee must remain in an Advanced Practice Clinician or Physician role within Home and Community for 36 months to receive the full benefit of the student loan repayments. Landmark Health, a part of Optum, was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to patients. Our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve. At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. Join Landmark to be part of a growing company full of purpose-driven, action-oriented, and compassionate team members working to dramatically transform healthcare for our communities. Together, we're making health care work better for everyone. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.


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