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Physician Leader - Value Based House Calls - Warwick, RI at UnitedHealth Group

Physician Leader - Value Based House Calls - Warwick, RI

UnitedHealth Group Work From Home, PA Full-Time

                                                 

This is a Full-Time Opportunity

                                                            $80,000 Student Loan Repayment or $20,000 Sign-on Bonus for external candidates

  

Landmark Health, part of the Optum and UnitedHealth Group family of businesses, was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are ill-equipped to navigate our overwhelming healthcare system.

Objective

Provides medical care and management to members served by Landmark Health. Works with the Regional Medical Director, Director of Health Services, Health Plan representatives, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs. Dedicated to improving the health and well-being of members; this position collaborates with existing PCPs if present, the Landmark multi-disciplinary team, the health plan Medical Director, and other health professionals, to develop members’ goals of care in all phases of longitudinal.

If you are located in Warwick, RI, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Functions as the day-to-day clinical leader of the multi-disciplinary team, providing decision support to team members providing care in the home to Landmark patients
  • In situations where there is no existing PCP for the patient, the Landmark Physician will assume responsibility as PCP to drive care and continuity for this patient
  • In situations where there is an existing PCP for the patient, the Landmark Physician helps to co-manage the patient with the PCP and functions as their extension into the home – the PCP’s eye and ears in the home
  • Assess patients’ needs in their place of residence, including:
    • Medical
    • Social
    • Psychological
    • Financial
    • Caregiver support
    • Environmental safety
  • Provide 24/7 medical coverage for assigned and covered patients (this can be as part of a call schedule)
  • Develop and update care plans and documentation of clinical encounters in the electronic medical
  • record as per Landmark’s Medical Records Policies
  • Provide same-day clinical assessment and treatment for pre-crisis intervention
  • Participates in management meetings that include, but may not be limited to:
    • Weekly case conference reviews
    • Monthly staff meetings
    • Schedule Joint Operating Committee meetings
    • Quarterly Quality Improvement Committee meetings
    • Continuing education/journal club programs
  • Performs an initial comprehensive assessment on all newly enrolled members and at least annually thereafter. Develops a member management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization. Meets with members and/or their legal representatives to review newly developed or modified care plans; involves the PCP in these meetings
  • Calls and communicates directly with patient’s PCP in real time to discuss any changes of condition and potential medication changes. Plans will be collaboratively decided on with PCP, but if unable to reach and emergent situation, NP/PA will render appropriate services and communicate changes at first available opportunity
  • Completes follow-up and post-hospital assessments according to documented standard operating procedure
  • Prescribes appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissions
  • Consults with hospital physicians following notification of member transfer
  • Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
  • Educates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellness
  • Addresses and documents advanced care planning and advanced directive wishes on initial visit and at least annually thereafter
  • Implements HEDIS measure campaigns and other quality initiatives as directed by Regional Medical Director to ensure the highest standards of care and to promote the improvement of care management and delivery
  • Routine caseload during business hours and scheduled on call after hours / weekends with possibility of home visits for crisis interventions
  • Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
  • In addition to routine history and physical exam in the home, will be trained and be proficient at such modalities including, but not limited to:
    • Insertion of IV
    • Venipuncture for blood draw
    • Wound care
    • Dressing changes
  • Catheter insertion and management
  • Demonstrate appropriate medical judgment and appropriate use of resources with regards to care plans, diagnostic testing and referrals
  • Develop solid patient-doctor and caretaker/family-doctor relationships so as to improve patient compliance with care plan
  • Work with the NCM to ensure care plan is meeting the clinical and psycho-social needs of the patient
  • Provide timely, evidence-based and appropriate patient care at all times
  • Complete and sign all documentation (including from vendors) within required timeframes
  • Maintain high levels of patient and family satisfaction
  • Arrange for transfers and placements to appropriate levels of care
  • Perform other duties as assigned

COMPETENCY:

  • Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics
  • Technical Skills - Assesses own strengths and weaknesses; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others
  • Interpersonal Skills - Focuses on solving conflict; maintains confidentiality; listens to others; keeps emotions under control and overcomes resistance when necessary; remains open to new ideas
  • Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and seeks clarification; responds openly to questions. Must be able to deal with frequent change, delays, or unexpected events
  • Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time
  • Initiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed; generates suggestions for improving work and workflow

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.

Required Qualifications:

  • Medical Doctorate or Doctorate of Osteopathy
  • Current, valid, non-sanctioned, non-restricted license to practice medicine in the state
  • Board Certified in Internal Medicine, Geriatrics sub-specialty or Family Practice [Board Eligible for up to 1 year if new grad]
  • Board Certified or Board Eligible in Internal Medicine, Geriatrics sub-specialty or Family Practice
  • Current DEA
  • 2+ years of clinical experience, home-based care desired
  • Extensive experience in providing medical care to geriatrics patients
  • Familiarity with Medicare Guidelines
  • Familiarity with CPT and ICD-9 codes as related to billing practices
  • Knowledge of clinical standards of care 
  • Malpractice profile meets Landmark’s risk guidelines
  • Ability to meet all Landmark Credentialing Requirements
  • Access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy
  • Full COVID-19 vaccination is an essential job function 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. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems

Physical Demands:

  • Regular requirement to sit; use hands to touch, handle or feel
  • Regular requirement to talk and listen
  • Occasional requirement to stand; walk and reach with hands and arms
  • Occasional requirement to lift and/or move up to 10 pounds
  • Vision abilities include close vision, peripheral vision, depth perception and ability to adjust focus
  • Ability to travel by plane or car

Work Environment:

  • Noise level is usually moderate

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)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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