UnitedHealth Group-posted 3 months ago
$104,500 - $156,000/Yr
Full-time • Entry Level
Onsite • Babylon, NY
Insurance Carriers and Related Activities

Home Base Medical Care, part of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team in Deer Park, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. Home Based Medical Care involves travel to patient residences. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

  • 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
  • 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
  • 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
  • Driver's license and access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy
  • 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
  • $40,000 Student Loan Repayment Or $30,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program
  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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