Nurse Practitioner - Full Time On Call - Community and State - MA - Full-time / Part-time

UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.

We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.

This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent, individuals with the tenacity and the dedication to make things work better for millions of people all over our country.

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

Position description:

1. Responsible for the delivery of medical care service to a pre-designated group of Senior Care Option and Nursing Home plan enrollees in collaboration with designated physicians.

2. Provide continuing primary care management.

3. Responsible for establishment and maintenance of effective external relationships with the Senior Care Options and Nursing Home Plan members, key decision-makers, facility staff, and collaborating physicians.

4. Responsible for establishment and maintenance of effective internal relationships with clinical and cross functional team members to build membership and ensure retention of current membership.

Primary Care Delivery

1. Delivers cost-effective, quality care to assigned members in collaboration with their assigned physicians.

2. Manages both medical and behavioral chronic and acute conditions effectively in collaboration with a physician or specialty provider.

3. Performs comprehensive assessments and documents findings in a concise/comprehensive manner that is compliant with visit and documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations.

4. Facilitates agreement and implementation of the member's plan of care by engaging the facility staff, families/responsible parties, primary and specialty care physicians while ensuring compliance.

5. Evaluates the effectiveness, necessity, and efficiency of the plan of care and makes revisions as needed.

6. Utilizes practice guidelines and protocols established by the Massachusetts Health Plan.

7. Required to participate in on-call program.

Care Coordination

1. Understands the Senior Care Options benefits and associate policies and procedures, and articulates them effectively to providers, members, and key decision-makers.

2. Assesses the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of any skilled benefit events and communicates process for providers in accordance with site expectations.

3. Coordinates care as members transition through different levels of care and care settings per Evercare protocol.

4. Ongoing monitoring of needs of members and families while facilitating any adjustments to the care plan as situations and conditions change.

5. Orders and interventions are reviewed for appropriateness and response to treatment to identify most effective plan of care in alignment with the members needs and wishes.

6. Evaluates plan of care for cost effective services that provide agreed upon outcomes for members, families and providers and decreases high costs, poor outcomes and unnecessary hospitalizations.

Program Enhancement

1. Regular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, Evercare staff and other provider groups.

2. Actively promotes the Senior Care Options program in assigned facilities by partnering with key stakeholders (i.e.: internal sales function, provider relations, facility leader) to maintain and develop membership growth.

3. Exhibits original thinking and creativity in the development of new and improved methods and approaches to concerns/issues.

4. Functions independently and responsibly with minimal need for supervision.

5. Demonstrates initiative in achieving individual, team, and organizational goals and objectives.

6. Participates in quality initiatives.

The culture is a fit for the person that loves to be part of a team and is flexible.

Keywords: nurse practitioner, Nurse Practitioner, Nurse practitioner, telecommute, telecommuter, telecommuting, work from home

1. Certified nurse practitioner through ANCC/AANP for adult, family and/or geriatrics (GNP preferred) or the ability to obtain.

2. Current unrestricted license in state(s) in which practicing or the ability to obtain.

3. Proficient computer skills including the ability to document medical information with written and electronic medical records.

4. Unrestricted DEA (license to prescribe narcotics/level II info here) per state regulations (unless prohibited in state of practice) or the ability to obtain.

5. Minimum of one year of hands-on post-grad Nurse Practitioner experience.

6. Nurse Practitioner experience in a long term care setting preferred.

Additional assets:

1. Medicare and Medicaid experience preferred

2. Flexibility with schedule and assignment

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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, 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.