Responsible for covering On-call hours as approximately one half of your workload, with the other half devoted to providing mentoring, coaching and support for APCs/PAs in the field. The Clinical Advisor partners with their Clinical Services Manager (CSM) to enhance clinical expertise and adherence to Optum's clinical model. If you are located in Ohio Region ( OH, IN, IL, WI, TX ) you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities : Clinical Advisor (Approximately 50%)The Clinical Advisor reports to and is supported by the Clinical Services Manager (CSM) Partner with CSM to ensure effective on-boarding of new clinicians and ongoing development of existing clinicians Orient new Nurse Practitioners to the On-call Team Provide mentoring and supervision to On-call Nurse Practitioners Assist CSM in development and management of on-call schedule Does not have direct reports but works in coordination with the CSM to enhance clinical expertise and adherence to the clinical model through planning and implementing the orientation and development of APC staff Oversee and implement clinical staff development programs in collaboration with market leadership Review work performed by others and provides recommendations for improvement in conjunction with supervisor Communicate needs and issues surfaced by clinical staff to site and corporate leadership Promote the development of a collegial team, for coverage, troubleshooting and brainstormingPrimary Care Delivery after hours (50%)Deliver cost-effective, quality care to assigned patients Manage both medical/behavioral chronic and acute conditions effectively in collaboration with a physician or specialty provider Perform comprehensive telephonic assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations. Perform a medication review before initiating new prescriptions and/or treatments Facilitate agreement and implementation of the patient'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 Attend regional staff meetings on at least a quarterly basis Maintain all applicable licensing and credentialing for all care sites within assigned geographic region Participate in holiday on-call rotation with other on-call APCs in assigned region Understand the Payer/Plan benefits, CCM associate policies, procedures and articulate them effectively to providers, patients, 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 patients transition through different levels of care and care settings Continually monitor the needs of patients 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 patient's needs and wishes Evaluate plan of care for cost effectiveness while meeting the needs of patients, families and providers to decreases high costs, poor outcomes and unnecessary hospitalizations Regular and effective communication with internal and external parties including physicians, patients, key decision-makers, nursing facilities, CCM staff and other provider groups Actively promote the CCM program in assigned territories 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 Work from home a combination of: Weekdays: 5 pm - 8 am 8 am - 8 pm & 8 pm - 8 am weekend & holidays (Saturdays and Sundays) - OVER NIGHT (must be awake) PLUS rotating holidays
Required Qualifications:Current, unrestricted NP license in the one of the posted state assignments plus ability to obtain licenses in all other HUB states DEA Licensure, or the ability to obtain DEA licensure / Prescriptive Authority post-hire in states where applicable 5+ years of experience as an NP Nurse Practitioner national certification as ANP, FNP, or GNP Master's Degree as a Nurse Practitioner A clinical background in adult, family or geriatric specialist Experience working in acute care, nursing home, or with seniors in other settings Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. For more information on our Internal Job Posting Policy, click here. 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. Job Keywords: Nurse Practitioner, NP, Clinical Advisor, CSM, Telecommute, On call, rotating shift, work from home, remote, Cincinnati, Cleveland, Milwaukee, Indianapolis, Chicago, Houston, Dallas, TX, Texas, Indiana, IN, Illinois, IL, Wisconsin, WI, Ohio, OH
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.