Nurse Practitioner or Physician Assistant - Port Huron, MI

Company: UnitedHealth Group
Location: Port Huron
Posted on: June 17, 2022

Job Description:

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)

Do you want to make a difference in healthcare?

Landmark Health, now part of the Optum 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.

Because many of our patients are frail and elderly, we deliver care primarily in the comfort of their home. Our Program is also offered to eligible patients - at no incremental financial cost to them . We are not a fee-for- service practice; we benefit economically only if we deliver high-quality patient outcomes and satisfaction. As a result, our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve.

At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral Health, and other employed team members.

Join Landmark to be part of a growing company full of purpose-driven, action-oriented, and compassionate team members working to dramatically transform healthcare for our communities.

The - Nurse Practitioner (NP) -or - Physician Assistant (PA) -provides medical care and management to members served by the program and participates in gathering clinical information for medical necessity determinations for service requests. The NP/PA works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, 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, the NP/PA collaborates with the PCP, and as needed, the health plan Medical Director and other health professionals, to develop members' goals of care in all phases of long-term care.

Primary Responsibilities:

Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing

Understands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communities

Establishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providers

Performs an initial comprehensive assessment on all newly enrolled members and bi-annually thereafter. Develops a member management care plan upon enrolment 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

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

Provides counsel, support and education to facility staff

Supports FCMs in developing and providing in-service educational programs to facility staff

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

Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery

On-call for caseload during business hours. May require some participation in clinical on-call program as plan expands

Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews

Perform related duties as necessary and other duties as assigned

Competencies:

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.

***Work Schedule: Mon-Fri from 8am-5pm ET with additional on-call reponsibilities***

Required Qualifications:

Completion of Nurse Practitioner or -Physician Assistant -accredited program

Current state RN or PA license for the state of Michigan

Current NP or PA license for the state of Michigan

Knowledge of CPT, ICD-9 and HCPC codes

Knowledge of clinical standards of care

Computer skills: internet navigation, Microsoft Office - Teams, Outlook, and Excel

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form

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 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

Preferred Qualification:

2+ years of clinical experience

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

Knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems

Physical Demands:

While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel

The employee is required to stand; walk and reach with hands and arms

The employee must occasionally lift and/or move up to 10 pounds

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

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)

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.

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