Nurse Practitioner Home Visits

7 days ago

Evergreen, United States UnitedHealth Group Full time

$10, Sign-on Bonus for External Candidates

Optum is seeking a Nurse Practitioner to join our Home-based Medical Care team in Jefferson County, CO. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.

As a member of the broader Home and Community Care team, you’ll help bring home-based medical care to complex, chronic patients. This life-changing work helps give older adults more days at home.

At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We’re connecting care to create a seamless health journey for patients across care settings. Join our team, it’s your chance to improve the lives of millions while Caring. Connecting. Growing together.

Positions in this function 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.

Position Highlights & Primary Responsibilities:

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursingUnderstands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communitiesEstablishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providersPerforms 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 meetingsCompletes follow-up and post-hospital assessments according to documented standard operating procedurePrescribes appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissionsConsults with hospital physicians following notification of member transferCollaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical servicesEducates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellnessProvides counsel, support and education to facility staffSupports FCMs in developing and providing in-service educational programs to facility staffParticipates in management meetings that include, but may not be limited to:Weekly case conference reviewsMonthly staff meetingsSchedule Joint Operating Committee meetingsQuarterly Quality Improvement Committee meetingsContinuing education/journal club programsImplements 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 deliveryOn-call for caseload during business hours. May require some participation in clinical on-call program as plan expandsKeeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviewsPerform related duties as necessary and other duties as assigned

Competencies:

To perform the job successfully, an individual should demonstrate the following competencies:

Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topicsTechnical Skills - Assesses own strengths and weaknesses; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with othersCustomer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitmentsInterpersonal Skills - Focuses on solving conflict; maintains confidentiality; listens to others; keeps emotions under control and overcomes resistance when necessary; remains open to new ideasOral Communication - Speaks clearly and persuasively in positive or negative situations; listens and seeks clarification; responds openly to questions. Must be able to deal with frequent change, delays, or unexpected eventsAttendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on timeDependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate planInitiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed; generates suggestions for improving work and workflow

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 programCurrent state RN licenseCurrent NP licenseKnowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systemsKnowledge of CPT, ICD-9 and HCPC codesKnowledge of clinical standards of careComputer Skills: To perform this job successfully, an individual should have knowledge of Windows and MS Office Word Processing softwareLanguage Skills: Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general publicMathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentReasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule formAccess 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 of clinical experienceAwareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems 


Physical Demands:

While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feelThe employee is required to stand; walk and reach with hands and armsThe employee must occasionally lift and/or move up to 10 poundsSpecific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus


Work Environment:

The noise level in the work environment is usually moderate


Colorado Residents Only: The salary range for this role is $88, to $, annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.


Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 


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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