UnitedHealth Group - White Plains, NY

posted about 1 month ago

Full-time - Entry Level
Onsite - White Plains, NY
Insurance Carriers and Related Activities

About the position

Optum is seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to join our Home-based Medical Care team in White Plains, NY. This role focuses on delivering home-based medical care to complex, chronic patients, particularly older adults, enhancing their quality of life by providing comprehensive medical services in their homes. The NP or PA will collaborate with an interdisciplinary team to develop and implement care plans, ensuring a seamless health journey for patients across various care settings.

Responsibilities

  • Practices in accordance with state laws and regulations governing advanced practice nursing.
  • Understands and complies with long-term care policies and procedures.
  • Establishes and maintains effective relationships with members, facility staff, and collaborating physicians/providers.
  • Performs initial comprehensive assessments on newly enrolled members and updates care plans as needed.
  • Completes follow-up and post-hospital assessments according to standard operating procedures.
  • Prescribes appropriate diagnostics and interventions to avoid unnecessary transfers or acute admissions.
  • Consults with hospital physicians following member transfers.
  • Collaborates with UM staff and PCPs to enable medical necessity determinations for requested services.
  • Educates members and their legal representatives on disease processes and wellness management.
  • Provides counsel and education to facility staff.
  • Supports FCMs in developing in-service educational programs for facility staff.
  • Participates in management meetings and quality improvement initiatives.
  • Implements HEDIS measure campaigns and other quality initiatives.
  • On-call for caseload during business hours and may participate in clinical on-call program as needed.
  • Keeps current on relevant medical and nursing research and technology.

Requirements

  • Completion of Nurse Practitioner or Physician Assistant accredited program.
  • Current state RN license if Nurse Practitioner.
  • Current NP or PA license.
  • Certification through AANP, ANCC, or NCCPA.
  • Knowledge of long-term care, community resources, and cost-effective patient care delivery systems.
  • Access to reliable transportation.

Nice-to-haves

  • 2+ years of clinical experience.
  • Knowledge of CPT, ICD-9, and HCPC codes.
  • Knowledge of clinical standards of care.
  • Awareness of NCQA requirements, CMS guidelines, and Medicaid/Medicare contracts.

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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