UnitedHealth Group
Location
Manchester, NH | United States
Job description
$40,000 Student Loan Repayment or $30,000 Sign-on Bonus for external candidates
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 Landmark product, we help bring home-based medical care to complex, chronic patients. This life-changing work helps give older adults more days at home.
We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
Position in this function works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well- being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients’ goals of care in all phases of the patient journey.
Primary Responsibilities:
Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing
Understands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communities
Establishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providers
Performs an initial comprehensive assessment on all newly enrolled members and bi-annually thereafter. Develops a member management care plan upon enrolment 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 meetings
Completes follow-up and post-hospital assessments according to documented standard operating procedure
Prescribes appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissions
Consults with hospital physicians following notification of member transfer
Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
Educates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellness
Provides counsel, support and education to facility staff
Supports FCMs in developing and providing in-service educational programs to facility staff
Participates in management meetings that include, but may not be limited to:
Weekly case conference reviews
Monthly staff meetings
Schedule Joint Operating Committee meetings
Quarterly Quality Improvement Committee meetings
Continuing education/journal club programs
Implements 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 delivery
On-call for caseload during business hours. May require some participation in clinical on-call program as plan expands
Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
Perform related duties as necessary and other duties as assigned
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 or Physician Assistant accredited program
Current state RN license if Nurse Practitioner
Current NP or PA license
Certification through the American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), or the National Commission on Certification of Physician Assistants (NCCPA)
Knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems
Access 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 experience
Knowledge of CPT, ICD-9 and HCPC codes
Knowledge of clinical standards of care
Awareness NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems
About OptumCare:
At OptumCare, we’ve found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving over 17 million people through more than 45,000 aligned physicians and 9,000 advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more at
Would you thrive with OptumCare?
Do you practice evidence-based medicine?
Are you seeking a practice focused on patient-centered quality care, not volume?
Are you a team player - comfortable delegating and empowering teams?
Are you constantly seeking better ways to do things?
Do you want to be part of something better?
New York Residents Only: The salary range for New York residents is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k 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.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
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.
Job tags
Salary
