Optum

posted 3 days ago

Full-time - Entry Level
Insurance Carriers and Related Activities

About the position

The CCM Nurse Practitioner/Physician Assistant per diem role at Optum Home & Community Care involves providing comprehensive medical care to members in various settings, including nursing homes and assisted living facilities. This position is integral to delivering quality healthcare services, managing both medical and behavioral conditions, and ensuring effective care coordination. The role emphasizes collaboration with physicians and facility staff to enhance patient care and improve health 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 care plan, making revisions as needed.
  • Utilize practice guidelines and protocols established by CCM.
  • Attend and complete all mandatory educational and training requirements.
  • Travel between care sites as required.

Requirements

  • Certified Nurse Practitioner or Physician Assistant through a national board.
  • For NPs: Graduate of an accredited master's degree in Nursing (MSN) program and board certified through AANP or ANCC.
  • For PAs: Graduate of an accredited Physician Assistant degree program and currently board certified by NCCPA.
  • 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 including the ability to document medical information with written and electronic medical records.
  • Ability to develop and maintain positive customer relationships.
  • Adaptability to change.

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
  • Sign-on bonus of $10,000 for external candidates
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