Job Description: $40,000 Student Loan Repayment Or $20,000 Sign-on Bonus For Individuals Who Have Not Previously Participated In This Program
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 Landmark product, we help bring home-based medical care to complex, chronic patients. This life-changing work helps give older adults more days at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
Works as a provider member within the HBMC interdisciplinary team in the direct delivery of home-based medical care of a population within an assigned geography. Dedicated to improving the health and wellbeing of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
Primary Responsibilities
- Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing or physician assistants
- Establishes and maintains effective relationships with patients, care givers, and/or their legal representatives, IDT members, PCPs, other collaborating physicians/providers, and facility staff when applicable
- Performs an initial comprehensive assessment on all newly enrolled patients and provides ongoing care thereafter. Develops a patient management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization.
- Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising physician in these meetings, when applicable
- Completes follow-up and post-discharge assessments according to documented standard operating procedure
- Prescribes appropriate diagnostics and interventions to avoid unnecessary acute admissions
- Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc. New hire and annual skills check/training provided
- Consults with hospital, emergency or post-acute clinical team following notification of patient transfer
- Educates patients and/or their legal representatives in disease processes affecting patients and ways to manage them effectively, as well as to promote wellness
- Provides counsel, support and education to staff as appropriate
- Actively participates in ongoing meetings pertaining to patient care and clinical excellence
- Implements HEDIS measure campaigns and other quality initiatives to ensure the highest standards of care and to promote the improvement of care management and delivery
- On-call for caseload during business hours. Participation in clinical after hours on-call program on rotational basis
- 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
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