Optum Home and Community
Company: Optum
Location: Spokane
Posted on: June 2, 2025
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Job Description:
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 Senior Community Care (SCC) product, we
work with a team to provide care to patients at home in a nursing
home, assisted living for senior housing. This life-changing work
adds a layer of support to improve access to care.
We're connecting care to create a seamless health journey for
patients across care settings. Join us to start Caring. Connecting.
Growing together. -
Serving millions of Medicare and Medicaid patients, Optum is the
nation's largest health and wellness business and a vibrant,
growing member of the UnitedHealth Group family of businesses. You
have found the best place to advance your advanced practice nursing
career. As an CCM Nurse Practitioner/ Physician Assistant you will
provide care to Optum members and be responsible for the delivery
of medical care services on a periodic or intermittent basis. -
Primary Responsibilities:
Primary Care Delivery
Deliver cost-effective, quality care to assigned members -
Manage both medical and behavioral, chronic and acute conditions
effectively, and 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 APC is responsible for ensuring that all quality elements are
addressed and documented -
The APC 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 CCM -
Must attend and complete all mandatory educational and LearnSource
training requirements -
Travel between care sites mandatory -
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
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Coordinate care as members transition through different levels of
care and care settings -
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 hospitalizations -
Program Enhancement Expected Behaviors
Regular 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 -
Ability to enter available hours into web-based application, at
least one month prior to available work time -
Demonstrate initiative in achieving individual, team, and
organizational goals and objectives -
Participate in CCM quality initiatives ------
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:
Certified Nurse Practitioner -through a national board
For NPs: Graduate of an accredited master's degree in Nursing (MSN)
program and board certified through the American Academy of Nurse
Practitioners (AANP) or the American Nurses Credentialing Center
(ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC
NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with
preferred certification as ANP, FNP, or GNP -
For PAs - Certified Physician Assistant through a national board:
Graduate of an accredited Physician Assistant degree program and
currently board certified by the National Commission on
Certification of Physician Assistants (NCCPA) -
Active and unrestricted license in the state which you reside -
Current active DEA licensure/prescriptive authority or ability to
obtain post-hire, per state regulations (unless prohibited in state
of practice) -
Ability to lift a 30-pound bag in and out of car and to navigate
stairs and a variety of dwelling conditions and configurations
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Ability to gain a collaborative practice agreement, if applicable
in your state
Access to reliable transportation that will enable you to travel to
client and/or patient sites within a designated area -
Preferred Qualifications:
1+ years of hands-on post grad experience within Long Term Care
Understanding of Geriatrics and Chronic Illness -
Understanding of Advanced Illness and end of life discussions -
Proficient computer skills including the ability to document
medical information with written and electronic medical records
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Proven ability to develop and maintain positive customer
relationships -
Proven adaptability to change -
The hourly range for this role is $43.17 to $84.95 per hour 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.
UnitedHealth Group is an Equal Employment Opportunity employer
under applicable law and qualified applicants will receive
consideration for employment without regard to race, national
origin, religion, age, color, sex, sexual orientation, gender
identity, disability, or protected veteran status, or any other
characteristic protected by local, state, or federal laws, rules,
or regulations. -
UnitedHealth Group is a drug-free workplace. Candidates are
required to pass a drug test before beginning employment. -
Keywords: Optum, Coeur d'Alene , Optum Home and Community , Healthcare , Spokane, Idaho
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