Per Diem NP or PA Senior Community Care in Jefferson County, NY
UnitedHealth Group - Watertown, NY
posted about 2 months ago
About the position
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 Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. 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 care settings. Join us to start Caring. Connecting. Growing together. As a CCM Nurse Practitioner/Physician Assistant per diem, you will provide care to Optum members and be responsible for the delivery of medical care services on a periodic or intermittent basis. Your primary responsibilities will include delivering cost-effective, quality care to assigned members, managing both medical and behavioral, chronic and acute conditions effectively, and collaborating with a physician or specialty provider. You will perform comprehensive assessments, document findings in a compliant manner, and ensure that all diagnoses are accurately coded and documented. Additionally, you will conduct medication reviews and facilitate the implementation of the member's plan of care by engaging with facility staff, families, and physicians. In this role, you will also be responsible for care coordination, understanding payer benefits, assessing medical necessity, and monitoring the needs of members and families. Regular communication with internal and external parties is essential, as is the ability to promote the CCM program in assigned facilities. You will be expected to function independently, demonstrate initiative, and participate in quality initiatives. This position requires travel between care sites and the ability to work flexible hours, including evenings and weekends.
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.
- Conduct initial medication reviews, 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 and specialty care physicians.
- Evaluate the effectiveness, necessity, and efficiency of the plan, making revisions as needed.
- Utilize practice guidelines and protocols established by CCM.
- Attend and complete all mandatory educational and Learnsource training requirements.
- Understand the Payer/Plan benefits, CCM associate policies, and articulate them effectively to providers, members, and key decision-makers.
- Assess the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate team members.
- Coordinate care as members transition through different levels of care and care settings.
- Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change.
- Review orders and interventions for appropriateness and response to treatment to identify the most effective plan of care that aligns with the member's needs and wishes.
- Evaluate the plan of care for cost-effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes, and unnecessary hospitalizations.
- Regular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, CCM staff, and other provider groups.
- Actively promote the CCM program in assigned facilities by partnering with key stakeholders to maintain and develop membership growth.
- 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.
- Demonstrate initiative in achieving individual, team, and organizational goals and objectives.
- Participate in CCM quality initiatives.
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 the AANP or ANCC, with preferred certification as ANP, FNP, or GNP.
- For PAs: Graduate of an accredited Physician Assistant degree program and currently board certified by the NCCPA.
- Active and unrestricted license in the state which you reside.
- Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations.
- Access to reliable transportation to travel to client and/or patient sites within a designated area.
- Ability to lift a 30-pound bag in and out of the car and navigate stairs and various dwelling conditions.
- Availability to work 24 hours per month, with expectations that 16 of the 24 hours/month could be during off-hours (after 5 pm, on weekends, and/or holidays).
- Ability to gain a collaborative practice agreement, if applicable in your state.
Nice-to-haves
- 1+ years of hands-on post-grad 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.
- Proven ability to develop and maintain positive customer relationships.
- Proven adaptability to change.
Benefits
- $5,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in This Program.
- Comprehensive benefits package including equity stock purchase and 401k contribution.
- Incentive and recognition programs.
