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Job description
Requisition number:
nJob category: Healthcare Delivery, Advanced Practice Clinicians
nOptum Home & Community Care, part of the Optum 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) team, we work to provide care to patients in nursing homes, senior housing and assisted living settings. 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 settings. Join us to start Caring. Connecting. Growing together.
nThe CA is responsible for managing up to approximately one half a case load and for providing mentoring, coaching and support for APCs and RNs in the field. The Clinical Advisor partners with their Clinical Services Manager (CSM), Clinical Team Lead (CTL) or Director of Clinical Operations (DCO) to enhance clinical expertise and adherence to Optum's clinical model.
nPrimary Responsibilities:
nnnSet team direction, resolve problems, and provide guidance to members of own team
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nnAdapt departmental plans and priorities to address business and operational challenges
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nnClinically mentor/teach team members as appropriate under the direction of CSM
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nnMaintain caseload of 50% or more patients and acquire patients according to team needs in conjunction with clinical advisor duties
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nnJOB DUTIES
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nnThe CA reports to and is supported by the CSM, CTL, or DCO
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nnPartner with the manager or supervisor to ensure effective on-boarding of new clinicians and ongoing development of existing clinicians
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nnDevelop innovative approaches and support the implementation and adoption of new clinical and quality initiatives
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nnDoes not have direct reports but works in coordination with the CTL, CSM, and/or DCO to enhance clinical expertise and adherence to the clinical model through planning and implementing the orientation and development of APC staff
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nnUtilize advanced clinical nursing expertise, knowledge of geriatric/chronic disease management, and the long-term care industry to provide coaching, mentoring, and role-modeling to new and existing clinicians
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nnOversee and implement clinical staff development programs in collaboration with market leadership
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nnReview work performed by others and provides recommendations for improvement in conjunction with supervisor
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nnServe as a resource to APCs/RNs for escalated complex and/or clinical issues
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nnPartner with clinicians and other site functions to ensure business development activities are in place to meet business goals
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nnSought out as knowledge-based expert
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nnCommunicate needs and issues surfaced by clinical staff to site and corporate leadership
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nnServe as a leader/ mentor
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nnPromote the development of a collegial team, for coverage, troubleshooting and brainstorming
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nnFoster and develop a culture of clinical expertise
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nnAnticipate customer needs and proactively develop solutions to meet them
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nnSolve complex problems and develop innovative solutions in collaboration with other stakeholders
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nnPerform complex conceptual analyses
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nnForecast and plan resource requirements
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nnAuthorize deviations from standards
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nnMay lead functional or segment teams and/or projects
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nnProvide explanations and information to others on complex issues
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nnMotivate and inspire other team members
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nnPRIMARY CARE DELIVERY
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nnDeliver cost-effective, quality care to assigned members
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nnManage both medical and behavioral chronic and acute conditions effectively in collaboration with a physician or specialty provider
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nnPerform 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
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nnEnsuring that all diagnoses are accurate and support the documentation for that visit
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nnThe APC is responsible for ensuring that all quality elements are addressed and documented
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nnThe APC will do an initial medication review, annual medication review and a post-hospitalization medication reconciliation
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nnFacilitate agreement and implementation of the member's plan of care by engaging the facility staff, families/responsible parties, primary and specialty care physicians
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nnEvaluate the effectiveness, necessity and efficiency of the plan, making revisions as needed
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nnUtilizes practice guidelines and protocols established by CCM
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nnMay be required to participate in on-call program
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nnTravel between care sites mandatory
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nnAfter hour on call coverage may be required
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nnCARE COORDINATION
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nnUnderstand the Payer/Plan benefits, CCM associate policies, procedures and articulate them effectively to providers, members and key decision-makers
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nnAssess 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
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nnCoordinate care as members transition through different levels of care and care settings
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nnContinually monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change
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nnReview 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
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nnEvaluate plan of care for cost effectiveness while meeting the needs of members, families and providers to decreases high costs, poor outcomes and unnecessary hospitalizations
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nnPROGRAM ENHANCEMENT EXPECTED BEHAVIORS
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nnRegular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, CCM staff and other provider groups
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nnActively 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
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nnExhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues
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nnFunction independently and responsibly with minimal need for supervision
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nnDemonstrate initiative in achieving individual, team and organizational goals and objectives
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nnParticipate in CCM quality initiatives
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nnPROFESSIONALISM:
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nnPersonal and Professional Accountability:
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nnCreate an environment that facilitates the team to initiate actions that produce positive results
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nnAbility to hold self and others accountable for actions and results in collaboration with CSM/CTL/DCO
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nnAnswers for one's own behavior and actions
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nnCareer Planning:
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nnDevelops own career path
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nnCoach others in the development of their career planning
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nnEthics:
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nnIntegrate high ethical standards and UHG core values into everyday work activities
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n nYou'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.
nRequired Qualifications:
nnnCertified Nurse Practitioner through a national board
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nnFor 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
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nnActive and unrestricted license in the state which you reside
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nnCurrent active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)
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nn1+ years of experience as an APC at Optum
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nnAccess to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
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nnAbility to move a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations
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nnAbility to gain a collaborative practice agreement, if applicable in your state
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n nPreferred Qualifications:
nnn2+ years of experience as an APC
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nn1+ years Medicare experience
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nnExperience in adult teaching environment
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nnAbility to develop and maintain positive customer relationships
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nnPossess knowledge and understanding of geriatrics clinical management
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nnAbility to work across functions and businesses to achieve business goals
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nnEffective in motivating and mentoring colleagues and peers
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nnAble to quickly adapt to change and drive change management within team and market
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nnPossess a high level of organizational skills, self- motivation, and ability to manage time independently
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nnProficient computer skills including the ability to document medical information with written and electronic medical records
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nnBasic excel skills and/or ability to learn excel
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n nCompensation for this specialty generally ranges from $115,000 - $172,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
nAt 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.
nUnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
nUnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Worksite address
norfolk, VA, 23500, US
Who can apply
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