Nurse Practitioner or Physician Assistant - Urgent Visits - Sterling / Harvard, MA
Company: Optum
Location: Leominster
Posted on: May 10, 2022
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Job Description:
Critical Care/ICU/PICU/NICU opening in Leominster,
Massachusetts. This and other physician assistant jobs brought to
you by DocCafe.com
Landmark Health, part of the Optum and UnitedHealth Group family of
businesses, 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.
Objective
This role primarily provides medical care and management to members
served by the Landmark program who request urgent visits to the NCM
on call from 8:00 AM to 5:00 PM Monday – Friday (Non-Holiday). This
position also participates in gathering clinical information for
medical necessity determinations for service requests. Works with
the Landmark Regional Medical Director, Director of Health
Services, and IDT 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
Working with the NCM schedules patients for maintenance visits in a
way and volume that allows prompt response to urgent patient
requests during normal business hours
Following the visit promptly communicates with the PCP and
specialist as needed along with communicating findings to their
primary assigned Landmark provider
Completes the required documentation in a timely manner (goal
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 at least 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
COMPETENCIES:
Problem Solving - Identifies and resolves problems in a timely
manner; gathers and analyzes information skillfully; develops
alternative solutions; works well in group problem solving
situations; uses reason even when dealing with emotional topics
Technical Skills - Assesses own strengths and weaknesses; pursues
training and development opportunities; strives to continuously
build knowledge and skills; shares expertise with others
Customer Service - Manages difficult or emotional customer
situations; responds promptly to customer needs; solicits customer
feedback to improve service; responds to requests for service and
assistance; meets commitments
Interpersonal Skills - Focuses on solving conflict; maintains
confidentiality; listens to others; keeps emotions under control
and overcomes resistance when necessary; remains open to new
ideas
Oral Communication - Speaks clearly and persuasively in positive or
negative situations; listens and seeks clarification; responds
openly to questions. Able to deal with frequent change, delays, or
unexpected events
Attendance/Punctuality - Is consistently at work and on time;
ensures work responsibilities are covered when absent; arrives at
meetings and appointments on time
Dependability - Follows instructions, responds to management
direction; takes responsibility for own actions; keeps commitments;
commits to long hours of work when necessary to reach goals;
completes tasks on time or notifies appropriate person with an
alternate plan
Initiative - Volunteers readily; undertakes self-development
activities; seeks increased responsibilities; takes independent
actions and calculated risks; looks for and takes advantage of
opportunities; asks for and offers help when needed; generates
suggestions for improving work and workflow
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 or Physician Assistant accredited
program
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
Access to reliable transportation; 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 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
Preferred Qualifications:
2+ years of clinical experience
Awareness about UM standards, NCQA requirements, CMS guidelines,
Milliman guidelines, and Medicaid/Medicare contracts and benefit
systems
Physical Demands:
Regular requirement to sit; use hands to touch, handle or feel
Regular requirement to talk and listen
Occasional requirement to stand; walk and reach with hands and
arms
Occasional requirement to lift and/or move up to 15 pounds
Vision abilities include close vision, peripheral vision, depth
perception and ability to adjust focus
Ability to travel frequently by car
Work Environment:
Noise level is usually moderate
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)
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
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.
UnitedHealth Group is a drug-free workplace. Candidates are
required to pass a drug test before beginning employment.
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Keywords: Optum, Leominster , Nurse Practitioner or Physician Assistant - Urgent Visits - Sterling / Harvard, MA, Healthcare , Leominster, Massachusetts
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