Full Time Nurse Practitioner - Youngstown Ravenna OH
$10,000 Sign-On Bonus for External Candidates
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)
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 UnitedHealth Group family of businesses. You have found the best place to advance your advanced practice nursing career. As an CCM APC you will provide care to your caseload of patients and be responsible for the delivery of medical care services to a pre-designated group of enrollees. We are looking for someone to cover the Youngstown Ravenna area in NE Ohio.
- Primary Care Delivery
- 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 Center for Medicare and Medicaid Services (CMS) regulations
- Providing a comprehensive clinical assessment for the Patient Connect members in a short term stay/transitional setting in collaboration with the case management team to support better care coordination and health outcomes
- With a focus on reduction in 30-day hospital readmissions in addition to other primary care responsibilities listed here
- Responsible for ensuring that all diagnoses are ICD10, 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 Learnsource 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
- Continually 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 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
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.
- Active and unrestricted license in the state which you reside
- Certified Nurse Practitioner or Physician Assistant through a national board
- For NPs: Graduate of an accredited master’s degree in Nursing (MSN) program or doctor of nursing practice (DNP) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP
- For PAs: Graduate of an accredited Physician Assistant degree program and currently board certified by the National Commission on Certification of Physician Assistants (NCCPA)
- Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
- Ability to gain a collaborative practice agreement, if applicable in your state
- Ability to lift a 30 pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations
- Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- 1+ years of hands-on post grad experience within long-term care, short-stay transitional setting care, and/or assisted living
- 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
- Ability to develop and maintain positive customer relationships
- Adaptability to change
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.