Nurse Practitioner
Company: UnitedHealth Group
Location: Lexington
Posted on: June 24, 2022
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Job Description:
Sign on Bonus for External Hires!** Combine two of the
fastest-growing fields on the planet with a culture of performance,
collaboration and opportunity and this is what you get. Leading
edge technology in an industry that's improving the lives of
millions. Here, innovation isn't about another gadget, it's about
making health care data available wherever and whenever people need
it, safely and reliably. There's no room for error. Join us and
start doing your life's best work.(sm) Serving millions of Medicare
and Medicaid patients, Optum is the nations 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. Primary Responsibilities: 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 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 members 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 members 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.
Required Qualifications: Active and unrestricted license in the
state which you reside, or license application pending. Certified
Nurse Practitioner through a national board For NPs: Graduate of an
accredited masters 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 Current active DEA licensure/prescriptive authority or ability
to obtain post-hire, per state regulations (unless prohibited in
state of practice) Access to reliable transportation that will
enable you to travel to client and/or patient sites within a
designated area Ability to lift a 30-pound bag in and out of car
and to navigate stairs and a variety of dwelling conditions and
configurations Ability to gain a collaborative practice agreement,
if applicable in your state Full COVID-19 vaccination is an
essential requirement 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 Preferred
Qualifications: 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. Here's the idea. We
built an entire organization around one giant objective; make
health care work better for everyone. So when it comes to how we
use the world's large accumulation of health-related information,
or guide health and lifestyle choices or manage pharmacy benefits
for millions, our first goal is to leap beyond the status quo and
uncover new ways to serve. Optum, part of the UnitedHealth Group
family of businesses, brings together some of the greatest minds
and most advanced ideas on where health care has to go in order to
reach its fullest potential. For you, that means working on high
performance teams against sophisticated challenges that matter.
Optum, incredible ideas in one incredible company and a singular
opportunity to do your life's best work.(sm) **PLEASE NOTE** The
Sign-On Bonus is only available to external candidates. Candidates
who are currently working for a UnitedHealth Group,
UnitedHealthcare or a related entity in a full time, part time, or
per diem basis (Internal Candidates) are not eligible to receive a
Sign On Bonus. 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
Keywords: UnitedHealth Group, Winston-Salem , Nurse Practitioner, Healthcare , Lexington, North Carolina
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