Nurse Practitioner - Senior Community Care - Per Diem - Kenosha, WI

Optum - Kenosha, WI

Full-time - Entry Level

Kenosha, WI

Insurance Carriers and Related Activities

About the position

The CCM Nurse Practitioner/Physician Assistant per diem role at Optum Home & Community Care involves providing medical care services to members in various settings, including nursing homes and assisted living facilities. This position is part of a team dedicated to delivering integrated care that addresses the physical, mental, and social needs of patients, ensuring they have access to necessary healthcare services. The role emphasizes collaboration with physicians and other healthcare providers to manage both chronic and acute conditions effectively, while also focusing on quality care delivery and patient outcomes.

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 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 and annual medication reviews and post-hospitalization medication reconciliations.
• Facilitate agreement and implementation of the member's plan of care by engaging facility staff, families, and primary/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 Payer/Plan benefits and articulate them effectively to providers, members, and key decision-makers.
• Assess the medical necessity/effectiveness of ancillary services and communicate the process to providers and team members.
• Coordinate care as members transition through different levels of care and settings.
• Monitor the needs of members and families while facilitating adjustments to the plan of care as situations change.
• Review orders and interventions for appropriateness and response to treatment.
• Evaluate plan of care for cost-effectiveness while meeting the needs of members, families, and providers.

Requirements

• Certified Nurse Practitioner through a national board.
• Graduate of an accredited master's degree in Nursing (MSN) program and board certified through AANP or ANCC.
• Active and unrestricted license in the state of residence.
• Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations.
• Access to reliable transportation for travel to client and/or patient sites.
• Ability to lift a 30-pound bag and navigate stairs and various dwelling conditions.
• Availability to work 24 hours per month, with expectations that 16 of those hours could be during off-hours.
• Ability to gain a collaborative practice agreement, if applicable in the state.

Nice-to-haves

• 1+ years of hands-on post-graduate experience within Long Term Care.
• Understanding of Geriatrics and Chronic Illness.
• Understanding of Advanced Illness and end-of-life discussions.
• Proficient computer skills for documenting medical information with written and electronic records.
• Ability to develop and maintain positive customer relationships.
• Adaptability to change.

Benefits

• $5,000 Sign-on Bonus for External Candidates