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in Islandia, NY

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Hours Full-time, Part-time
Location Long Island, NY
Islandia, New York

About this job

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
 
Primary Responsibilities: 

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
The NP is responsible for ensuring that all diagnoses are ICD9/ICD10 coded accurately and documented appropriately to support the diagnosis at that visit
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, 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 mandatory
After hour on call coverage may be required 
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 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 member's 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, Optum staff and other provider groups
Actively promote the Optum programs in community (Skilled nursing facility, Assisted living facility, community) by partnering with key stakeholders (i.e.: internal sales function, provider relations, facility leader) 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

Required Qualifications:

Proficient computer skills including the ability to document medical information with written and electronic medical records
Understanding of Geriatrics and Chronic Illness
Ability to develop and maintain positive customer relationships
Adaptability to change
Understanding of Advanced Illness and end of life discussions
Certified nurse practitioner through ANCC/AANP for adult, family and/or geriatrics (GNP preferred)
Current unrestricted license in state(s) in which practicing
Unrestricted DEA (license to prescribe narcotics/level II info here) per state regulations (unless prohibited in state of practice)
Preferred Qualification:

Prior experience as a Nurse Practitioner in a long term care setting or community setting for a minimum of one year
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: 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.
 
 
Job Keywords: Nurse Practitioner, NP, long term care, LTC, Assisted Living, Nursing Home, Primary Care, Brooklyn, Staten Island, NY, New York
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