Geauga Counties OH (greater Eastern Cleveland)

UnitedHealth Group•Painesville, OH

24d•$91,700 - $163,700•Hybrid

About The Position

Optum Home & Community Care, part of the Optum 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) team, we work to provide care to patients in nursing homes, senior housing and assisted living settings. 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 settings. Join us to start Caring. Connecting. Growing together. This role supports Optum Senior Community Care’s SNF Patient Connect Program, a unique, one-time visit initiative designed for UnitedHealthcare members transitioning from hospitalization to a skilled nursing facility (SNF) and ultimately back home. The program focuses on improving care transitions, reducing 30-day hospital readmissions, and enhancing overall patient outcomes during a critical stage in the healthcare journey. In this autonomous role, the Advanced Practice Clinician (APC) conducts a comprehensive, one-time health assessment in collaboration with the case management team to support effective care coordination. The visit emphasizes accurate and complete documentation of acute and chronic conditions, improved coding accuracy, and increased closure of STAR/HEDIS quality measures, including support for Advanced Care Planning directives. The APC plays a key role in educating patients and supporting both patients and families during a vulnerable transition period, while also communicating pertinent findings to attending providers and facility staff. Unlike traditional clinical roles, the APC does not manage ongoing care or carry responsibility for orders, treatments, or follow-up, allowing greater focus on assessment, insight, and impact. This position offers the opportunity to work independently across varied care settings, leveraging clinical expertise to improve patient satisfaction, strengthen discharge planning, and enhance post-discharge support. It is a highly rewarding role for clinicians seeking autonomy while making a meaningful difference in the lives of a complex patient population.

Requirements

For NPs: Active ANCC or AANP certification in Family, Adult, Geriatric, or Adult-Gerontology Primary Care
For PAs: Current NCCPA certification and state licensure
Active, unrestricted licensure in the state you will be practicing in (or ability to obtain by start date) without current disciplinary actions or practice limitations
Active and unrestricted driver's license
In addition to a driver's license, access to reliable transportation
Ability to gain a collaborative practice agreement, if applicable in your state
Availability to work 40 hours per week
Ability to move a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations
Ability to navigate varied environments and to position oneself as needed to perform job duties
Proficient computer skills including the ability to document medical information with written and electronic medical records

Nice To Haves

1+ years of clinical experience as an APC (long-term care setting preferred)
Experience in geriatric medicine, long-term care, senior living or home care setting
Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs
Understanding of Geriatrics and Chronic Illness
Understanding of Advanced Illness and end of life discussions
Proficiency with electronic medical records and technology

Responsibilities

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
Responsible for ensuring that all diagnoses are ICD10, coded accurately, and documented appropriately to support the diagnosis at that visit
The APC is responsible for ensuring that all quality elements are addressed and documented
The APC will do an initial medication review
Must attend and complete all mandatory educational and computer/virtual training requirements
Travel between care sites mandatory
Care Coordination
Communicate with the patient and necessary team members regarding any medical concerns at the time of your visit
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
Ability to enter available hours into web-based application, at least one month prior to available work time
Demonstrate initiative in achieving individual, team, and organizational goals and objectives
Participate in SCC quality initiatives
Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling