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.
Please Note: This position is a remote Management role that requires quarterly overnight travel to DFW and Houston.
As a team member of our Landmark service, we help bring home-based medical care to complex, chronic patients. This lifechanging 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.
Primary Responsibilities:
Clinical Expertise & Leadership:
- Functions as the primary day-to-day clinical leader of the interdisciplinary care team (IDT), providing clinical decision-making support, curbside consultations, ride alongs, and comprehensive chart reviews (in accordance with state-specific CPA requirements) to ensure we maintain a high level of patient and caregiver satisfaction and exceptional clinical outcomes
- Performs chart reviews and leads discussions with the interdisciplinary team to ensure that care plans meet the clinical and psycho-social needs of patients, promoting coordinated and holistic care
- Demonstrates exceptional medical judgment and resource utilization in developing care plans, ordering diagnostic tests, and making appropriate referrals for the highest complexity patients
- Executes on HEDIS measure campaigns and other quality initiatives as directed by the Market Medical Director (MMD) and Associate Medical Director (AMD). Hold team members accountable to the highest standards of care management and delivery to enhance patient outcomes
- Participates in and lead clinical management meetings (e.g., daily huddle, weekly case reviews and IDT meetings, and weekly provider meetings)
- Keeps current on relevant medical research, technology, and related issues by attending continuing education courses, professional meetings, and journal reviews
Team Management:
- Manages a team of 6-10 advanced practice clinicians, providing guidance, mentorship, and support to optimize their performance and professional development
- Responsible for all administrative duties related to people management such as PTO, FMLA, coaching, and performance reviews
- Create and foster a team culture that is collaborative and patient-centric
- Advocate to relevant stakeholders regarding internal issues, challenges, barriers, and needed changes
- Monitor team-level performance metrics (e.g., admission/readmission rates, length of stay, CHF, COPD) in order to identify opportunities to deliver high quality patient care
In-Home Co-Management of Complex Patients:
- Provide comprehensive medical care to our most complex patients in their place of residence through effective co-management of patients with their assigned longitudinal APC provider. Apply clinical expertise to guide team members to effectively assess and address patient’s medical, urgent, social, psychological, financial, caregiver support, and environmental safety needs. Percentage of patient-facing time can vary significantly to as high as 40% when short staffed
- Apply clinical expertise to develop and update individualized care plans for patients, documenting clinical encounters accurately in the electronic medical record. Foster strong patient-provider and caretaker/family-provider relationships to enhance patient compliance with the care plan
- Rotate on-call duties to provide after-hours urgent care coverage for medically complex patients, ensuring continuity of care
- Arrange placement of patients to appropriate levels of care, collaborating with relevant healthcare facilities and providers
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:
- Active NP or PA license. Licensure must be unencumbered, free of any open/unresolved disciplinary actions including probation or restrictions against privilege to practice
- Extensive experience in providing medical care to geriatrics and/or seriously ill patients
- Understanding of patient care quality metrics (e.g., HEDIS, Stars, disease-based metrics) in order to drive team members to achieve quality outcomes
- Ability to complete physical requirements of the job including lifting a 30-pound bag in and out of a vehicle, navigating stairs and a variety of dwelling conditions, and sit, stand, and kneel to perform physical assessment
- Ability to travel quarterly to Houston and DFW area
Preferred Qualifications:
- 5+ years of clinical experience, preferably in home-based care
- 3+ years of leadership and/or management experience in a healthcare setting
- If reside in Texas - reliable transportation to complete home visits; if you are driving a vehicle, you must comply with all the terms of the Optum Motor Vehicle Safety policy
- Experience utilizing Ubiquity EMR
- Familiarity with CPT and ICD-10 codes
- Knowledge of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems
The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
