Nurse Practitioner - CA
Company: UnitedHealth Group
Location: Concord
Posted on: June 21, 2022
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Job Description:
$20,000 Sign on Bonus for External Hires
Landmark Health was created to transform how healthcare is
delivered to the most medically vulnerable members in our
community. Our medical group provides home-based medical care to
chronically ill patients, many of whom are ill-equipped to navigate
our overwhelming healthcare system.
Because many of our patients are frail and elderly, we deliver care
primarily in the comfort of their home. Our Program is also offered
to eligible patients at no incremental financial cost to them. We
are not a fee-for-service practice; we benefit economically only if
we deliver high-quality patient outcomes and satisfaction. As a
result, our clinical teams can spend quality-time caring for a
smaller number of patients, giving all patients the space, respect,
compassion and care they deserve.
At Landmark, our interdisciplinary teams collaboratively manage our
complex patient panels. These teams are led by Physicians, Nurse
Practitioners, and Physician Assistants, with supporting care
provided by RN Nurse Care Managers, Social Workers, Pharmacists,
Behavioral Health, and other employed team members.
Join Landmark to be part of a growing company full of
purpose-driven, action-oriented, and compassionate team members
working to dramatically transform healthcare for our
communities.
This role provides medical care and management to members served by
the program and participates in gathering clinical information for
medical necessity determinations for service requests. Works with
the Landmark Health Medical Director, Director of Health Services,
Corporate Director of Health Services, and UM staff in the
development and/or implementation of medical management policy,
clinical protocols, utilization management guidelines, and quality
management programs. Dedicated to improving the health and
well-being of members, this position collaborates with the PCP, and
as needed, the health plan Medical Director and other health
professionals, to develop members' goals of care in all phases of
long-term care.
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 enrollment 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
Knowledge of long-term care, community resources and cost-effective
alternatives regarding patient care delivery systems
Knowledge of CPT, ICD-9 and HCPC codes
Knowledge of clinical standards of care
Knowledge of Windows 2000 and MS Office Word Processing
software
Access to reliable transportation required; if you are driving a
vehicle, you must comply with all the terms of the Landmark Motor
Vehicle Safety policy
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:
2+ years of clinical experience
Awareness about UM standards, NCQA requirements, CMS guidelines,
Milliman guidelines, and Medicaid/Medicare contracts and benefit
systems is helpful
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)
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, Concord , Nurse Practitioner - CA, Healthcare , Concord, California
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