As an CPM Nurse Practitioner you will provide care to your caseload of patients. You will be responsible for the delivery of medical care services to a pre-designated group of enrollees. Primary Responsibilities: Launch Active role in Launch Month implementation process Engagement with new facilities and facility relationship. However, Market will own the relationship Responsible for performing back fill duties per new effective as driven by market need Initiate and communicate a written detailed reporting off document to market staff Included in this document will be the tracking grid as defined by the market Primary Care Delivery Deliver cost-effective, quality care to assigned members Manage both medical and behavioral chronic and acute conditions effectively 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 NP is responsible for ensuring that all quality elements are addressed and documented The NP 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 CPM May be required to participate in on-call program Travel between care sites is based on the needs of business/market and required for the role Expected Travel 75% - 100% 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 Continually 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 hospitalizationsProgram Enhancement Expected BehaviorsRegular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, CCM staff and other provider groups Actively promote the CCM program in assigned facilities 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. Participate in CCM quality initiative Meet performance expectations
Required Qualifications: Prior experience and ability to perform both acute and chronic medical management Understanding of Geriatrics, Acute, and Chronic Illness Ability to develop and maintain positive customer relationships Understanding of Advanced Illness and end of life discussions Certified nurse practitioner through ANCC/AANP for adult, family and/or geriatrics Masters prepared in compliance with state licensure requirements for assigned states covering Credentialed in facilities where required Current unrestricted license in state(s) in which practicing. Unrestricted DEA (license to prescribe narcotics/level II) per state regulations (unless prohibited in state of practice) Currently have prescriptive authority or have no limitations to be granted prescriptive authority at time of hire and while in role. This will be based on state/markets hired to cover Proficient computer skills with Microsoft Office suite of products including Outlook and Excel Ability to document medical information in written and electronic medical records Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated areaPreferred Qualifications: Prior experience as a Nurse Practitioner in a long term care setting or community setting for a minimum of one year. Adaptability to change UnitedHealth Group is working to create the health care system of tomorrow.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. 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 Jobs, Geriatric Nurse Practitioner, NP, long term care, LTC, Assisted Living, Nursing Home, Primary Care, Wisconsin, WI, Milwaukee, Madison, Chicago, Illinois, IL, Springfield, IL
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.