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Posted: 01-Nov-24
Location: Clermont, Florida
Salary: Open
Categories:
Internal Number: 143914546
$10,000 Sign-on Bonus for individuals who have not previously participated in this program.
Optum is seeking a Nurse Practitioner to join our Home-based Medical Care team in Clermont and Apopka, FL. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.
As a member of the broader Home and Community Care team, you’ll help bring home-based medical care to complex, chronic patients. This life-changing work helps give older adults more days at home.
At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We’re connecting care to create a seamless health journey for patients across care settings. Join our team, it’s your chance to improve the lives of millions while Caring. Connecting. Growing together.
Position in this function works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and well- being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients’ goals of care in all phases of the patient journey.
Position Highlights & Primary Responsibilities:
- 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. Meets with members and/or their legal representatives to review newly developed or modified care plans; involves the PCP in these meetings
- 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
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Completion of Nurse Practitioner accredited program
- Current state RN license
- Current NP license
- Certification through the American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC)
- Proven knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems
- Access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy
Preferred Qualifications:
- 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
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
