Per Diem NP or PA Senior Community Care – Monroe County, NY Position Available In Richmond, New York

$5,000 Sign-on Bonus for External Candidates Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere. As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

Primary Responsibilities:

Primary Care Delivery Deliver cost-effective, quality care to assigned members Manage both medical and behavioral, chronic and acute conditions effectively, and 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 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 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