Complex Care Nurse Practitioner for Optum - Tucson, Arizona - Full-time / Part-time

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. We're also the career home for Nurse Practitioners who

bring compassion and passion, energy and focus to their work every day. 

In this role, you will provide primary care to patients in long term care or community settings. You will be responsible for the delivery of medical care services to a pre-designated group of enrollees.
Listen to our NPs describe their work: Nurse Practitioner Video
Key responsibilities of the NP include:

Primary Care Delivery:
• Deliver cost-effective, quality care to assigned members.
• Manage both medical and behavioral, chronic and acute conditions effectively,  collaborating with a physician or specialty provider as indicated.
• 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.
• The NP is responsible for ensuring that all diagnoses are ICD9/ICD10 coded accurately and documented appropriately to support the diagnosis.
• The NP is responsible for ensuring that all quality elements are addressed and documented.
• The NP 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 of care, making revisions as needed.
• Utilizes practice guidelines and protocols established by CPM.
• May be required to participate in On-Call program.
• Travel between care sites is mandatory.

Care Coordination:
• Understand the Payer/Plan benefits, Optum 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 member's transition through different levels of care and care settings.
• Continually monitor the needs of members and families and 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 the 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 minimize health care costs, poor outcomes and unnecessary hospitalizations.

 Program Enhancement Expected Behaviors:
• Regular and effective communication with internal and external parties, including members, physicians, key decision-makers, nursing facilities, Optum staff and other provider groups.
• Actively promote Optum programs  (Skilled nursing facility, Assisted living facility, Community) by partnering with key stakeholders (i.e.: internal sales force , provider relations, facility leadership) to maintain and develop
membership caseload.
• 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 Optum quality initiatives.

Requirements:

Experience:
• Prior experience as a Nurse Practitioner in a primary patient care role setting for a minimal of one year.  Long term or community homebase care setting  preferred.
• Proficient computer skills including the ability to document medical information with written and electronic medical records, use of Microsoft Word and Excel, and Outlook is essential.

Knowledge & Skills:
• Understanding of Geriatrics and Chronic Illness syndromes
• Understanding of Advanced Illness and comfort with End of Life discussions
• Ability to develop and maintain positive customer relationships
• Adaptability to change

Licensure Requirement:
• Certified nurse practitioner through ANCC/AANP for adult, family and/or geriatrics required (GNP preferred).
• Current unrestricted license in state(s) in which practicing.
• Unrestricted DEA (license to prescribe narcotics) per state regulations (unless prohibited in state of practice).

Additional Qualifications:
• Ability to lift up to 40 pounds.
• Must possess a valid Driver's License, dependable transportation and automobile insurance,  with the ability to travel between nursing homes and/or care settings.
• Personal smart phone with ability to apply the GOOD application for secured e-mails; phone expense reimbursement available
 
What happens when you join our expanding, Fortune 17 organization?  You will share our mission to improve the health of others and help heal the health care system. You'll work within an incredible team culture; a clinical and business

collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.  

If you want more meaning in your career - as a clinician or a business professional – take this opportunity to apply.  It's the first step in a new career that will enable you to do your life's best work.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Job Keywords: Job, Nurse Practitioner, NP, long term care, LTC, Assisted Living, Nursing Home, Primary Care, Home Health, Home Care, Community