Optum - Salt Lake City, UT
posted 4 months ago
About the position
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental, and social needs - helping patients access and navigate care anytime and anywhere. 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. Join us to start Caring. Connecting. Growing together. We're fast becoming the nation's largest employer of Nurse Practitioners; offering a superior professional environment and incredible opportunities to make a difference in the lives of patients. 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. 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 on a periodic or intermittent basis.
Responsibilities
- Deliver cost-effective, quality care to assigned members.
- Manage both medical and behavioral, chronic and acute conditions effectively, 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.
- Ensure that all diagnoses are ICD10 coded accurately and documented appropriately to support the diagnosis at that visit.
- Address and document all quality elements as required.
- Conduct initial medication reviews, annual medication reviews, and post-hospitalization medication reconciliations.
- Facilitate agreement and implementation of the member's plan of care by engaging facility staff, families/responsible parties, 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 LearnSource training requirements.
- Travel between care sites as required.
- 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.
- Regularly communicate effectively 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/issues.
- Function independently and responsibly with minimal need for supervision.
- Demonstrate initiative in achieving individual, team, and organizational goals and objectives.
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.
- For PAs - Certified Physician Assistant through a national board: Graduate of an accredited Physician Assistant degree program and currently board certified by the National Commission on Certification of Physician Assistants (NCCPA).
- Active and unrestricted license in the state which you reside.
- 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 you to travel to client and/or patient sites within a designated area.
- 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) not to exceed 960 hours in a calendar year.
- Ability to gain a collaborative practice agreement, if applicable in your state.
Nice-to-haves
- 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.
- Proven ability to develop and maintain positive customer relationships.
- Proven adaptability to change.
Benefits
- $5,000 Sign-on Bonus for External Candidates
- Opportunities for professional development and growth
- A supportive work environment that values initiative and performance
