Nurse Practitioner or Physician Assistant; Per Diem - Hartford & Middlesex Counties - Senior C

$5,000 Sign On Bonus for External Candidates

Optum Home & Community Care, part of the United Health 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.

We re fast becoming the nation s largest employer of Nurse Practitioners; offering a superior professional environment and incredible opportunities to make a difference in the lives of patients. This growth is not only a testament to our model s success but the efforts, care, and commitment of our Nurse Practitioners.

Serving millions of Medicare and Medicaid patients, Optum is the nation s largest health and wellness business and a vibrant, growing member of the United Health Group family of businesses. You have found the best place to advance your advanced practice nursing career. 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 in a periodic or intermittent basis.

• Primary Care Delivery
  • Deliver cost-effective, quality care to assigned members
  • Manage both medical and behavioral, chronic and acute conditions effectively, and 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 Center for Medicare and Medicaid Services (CMS) regulations
  • Responsible for ensuring that all diagnoses are ICD
    10, 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, annual medication review and a post-hospitalization medication reconciliation
  • Facilitate agreement and implementation of the member s plan of care by engaging the facility staff, families/responsible parties, primary and specialty care physicians
  • Evaluate the effectiveness, necessity and efficiency of the plan, making revisions as needed
  • Utilizes practice guidelines and protocols established by CCM
  • Must attend and complete all mandatory educational and Learn Source training requirements
  • Travel between care sites mandatory
• Care Coordination
  • Understand the Payer/Plan benefits, CCM associate policies, procedures 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 most effective plan of care that aligns with the member s needs and wishes
  • Evaluate plan of care for cost effectiveness while meeting the needs of members, families and providers to decreases high costs, poor outcomes and unnecessary hospitalizations
• Program Enhancement Expected Behaviors
  • 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 (i.e. internal sales function, provider relations, facility leader) to maintain and develop membership growth
  • Exhibit original thinking…