Nurse Practitioner - Full Time - Optum CarePlus - Pueblo, CO

• 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

• 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

• 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

Required Qualifications: 

Preferred Qualifications:

UnitedHealth Group is working to create the health care system of tomorrow. 
 
Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
 
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
 
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
 

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: Job, Nurse Practitioner, NP, long term care, LTC, Assisted Living, Nursing Home, Primary Care, Acute Care, Pueblo, CO, Colorado, geriatric home health, acute rehab