**$20,000 Sign on Bonus for External Hires!**
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
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 of businesses. You have found the best place to advance your advanced practice nursing career. As an CCM APC you will provide care to your caseload of patients and be responsible for the delivery of medical care services to a pre-designated group of enrollees.
This is a field position serving Charlotte, NC. Full time days.
- Primary Care Delivery
- 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.
- Providing a comprehensive clinical assessment for the Patient Connect members in a short term stay/transitional setting in collaboration with the case management team to support better care coordination and health outcomes.
- With a focus on reduction in 30-day hospital readmissions in addition to other primary care responsibilities listed here.
- Responsible for ensuring that all diagnoses are ICD10, coded accurately, and documented appropriately to support the diagnosis at that visit.
- The APC is responsible for ensuring that all quality elements are addressed and documented.
- The APC 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 CCM.
- Must attend and complete all mandatory educational and Learnsource training requirements.
- Travel between care sites mandatory.
- Care Coordination
- Understand the Payer/Plan benefits, CCM 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 members 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, CCM staff and other provider groups.
- Actively promote the CCM program in assigned facilities by partnering with key stakeholders (i.e.: internal sales function, provider relations, facility leader) to maintain and develop membership growth.
- 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 CCM quality initiatives.
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.
- Active and unrestricted license in the state which you reside, or the ability to obtain.
- Certified Nurse Practitioner or Physician Assistant through a national board
- For NPs: Graduate of an accredited master’s degree in Nursing (MSN) program or doctor of nursing practice (DNP) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP.
- For PAs: Graduate of an accredited Physician Assistant degree program and currently board certified by the National Commission on Certification of Physician Assistants (NCCPA).
- Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice).
- Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area.
- Ability to lift a 30 pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations.
- Ability to gain a collaborative practice agreement, if applicable in your state
- Full COVID-19 vaccination is an essential requirement 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
- 1+ years of hands-on post grad experience within long-term care, short-stay transitional setting care, and/or assisted living
- 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
- Proficient computer skills including the ability to document medical information with written and electronic medical records
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)
**PLEASE NOTE** The Sign-On Bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a Sign On Bonus.
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 by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.