Nurse Practitioner or Physician Assistant - North Shore Boston
Company: UnitedHealth Group
Location: Lynn
Posted on: May 5, 2022
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Job Description:
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 the
program and participates in gathering clinical information for
medical necessity determinations for service requests. 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, this position 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 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
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
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
Customer Service - Manages difficult or emotional customer
situations; responds promptly to customer needs; solicits customer
feedback to improve service; responds to requests for service and
assistance; meets commitments
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
Dependability - Follows instructions, responds to management
direction; takes responsibility for own actions; keeps commitments;
commits to long hours of work when necessary to reach goals;
completes tasks on time or notifies appropriate person with an
alternate plan
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:
Education and/or Experience:
Completion of Physician Assistant or Nurse Practitioner accredited
program
Knowledge of long-term care, community resources and cost-effective
alternatives regarding patient care delivery systems
Knowledge of CPT, ICD-9 and HCPC codes
Knowledge of clinical standards of care
Language Skills:
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
Mathematical Skills:
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
Reasoning Ability:
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
Computer Skills:
Knowledge of Windows 2000 and MS Office Word Processing
software
Certificates, Licenses, Registrations:
Current state RN license (if applicable)
Current NP or PA license
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 Qualifications:
2+ years of clinical experience
Awareness about UM standards, NCQA requirements, CMS guidelines,
Milliman guidelines, and Medicaid/Medicare contracts and benefit
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:
The noise level in the work environment 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.
Keywords: UnitedHealth Group, Lynn , Nurse Practitioner or Physician Assistant - North Shore Boston, Healthcare , Lynn, Massachusetts
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