Nurse Practitioner or Physician Assistant - NYC

$88,000 - $173,200/Yr

Optum - New York, NY

Full-time - Mid Level

New York, NY

Insurance Carriers and Related Activities

About the position

Optum is seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to join the Home-based Medical Care team in Queensbury, NY. This role focuses on delivering home-based medical care to complex, chronic patients, particularly older adults, enhancing their quality of life by providing comprehensive medical services in their homes. The position involves collaboration with various healthcare professionals to develop and implement care plans that address the physical, mental, and social needs of patients, ensuring a seamless health journey across care settings.

Responsibilities

• Practice in accordance with state laws and regulations governing advanced practice nursing.
• Understand and comply with long-term care policies and procedures.
• Establish and maintain effective relationships with members, their legal representatives, facility staff, and collaborating physicians/providers.
• Perform initial comprehensive assessments on newly enrolled members and bi-annual assessments thereafter.
• Develop and update member management care plans as needed.
• Meet with members and/or their legal representatives to review care plans and involve the PCP in these discussions.
• Complete follow-up and post-hospital assessments according to standard operating procedures.
• Prescribe appropriate diagnostics and interventions to avoid unnecessary transfers or acute admissions.
• Consult with hospital physicians following member transfers.
• Collaborate with UM staff and PCPs to enable medical necessity determinations for requested services.
• Educate members and their representatives on disease processes and wellness management.
• Provide counsel and support to facility staff and assist in developing educational programs.
• Participate in management meetings and quality improvement initiatives.
• Implement HEDIS measure campaigns and other quality initiatives as directed.
• Be on-call for caseload during business hours and participate in clinical on-call programs as needed.
• Stay current on medical and nursing research and attend continuing education courses.

Requirements

• Completion of Nurse Practitioner or Physician Assistant accredited program.
• Current state RN license if Nurse Practitioner.
• Current NP or PA license.
• Certification through AANP, ANCC, or NCCPA.
• Knowledge of long-term care, community resources, and cost-effective patient care delivery systems.
• Access to reliable transportation.

Nice-to-haves

• 2+ years of clinical experience.
• Knowledge of CPT, ICD-9, and HCPC codes.
• Knowledge of clinical standards of care.
• Awareness of NCQA requirements, CMS guidelines, and Medicaid/Medicare contracts.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution