- Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing
- Understands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communities
- Establishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providers
- Performs an initial comprehensive assessment on all newly enrolled members and bi-annually thereafter. Develops a member management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization. Meets with members and/or their legal representatives to review newly developed or modified care plans; involves the PCP in these meetings
- Completes follow-up and post-hospital assessments according to documented standard operating procedure
- Prescribes appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissions
- Consults with hospital physicians following notification of member transfer
- Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
- Educates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellness
- Provides counsel, support and education to facility staff
- Supports FCMs in developing and providing in-service educational programs to facility staff
- Participates in management meetings that include, but may not be limited to:
- Weekly case conference reviews
- Monthly staff meetings
- Schedule Joint Operating Committee meetings
- Quarterly Quality Improvement Committee meetings
- Continuing education/journal club programs
- Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery
- On-call for caseload during business hours. May require some participation in clinical on-call program as plan expands
- 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
- Completion of Nurse Practitioner or Physician Assistant accredited program
- Licensed as a NP or PA-C in State where you will be practicing
- Demonstrated knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems
- Proven knowledge of CPT, ICD-9 and HCPC codes
- Proven knowledge of clinical standards of care
- Access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy
- 2+ years of clinical experience
- Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems
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Lancaster Pennsylvania Family Medicine Position
3 weeks ago
The Curare Group Lancaster, United StatesMulti-specialty group with over 50 physicians in Philadelphia, PA is searching for a Board Eligible/Board Certified physician for their Primary Care opening. This position is 100% outpatient and offers the opportunity for partnership. Enjoy a competitive base salary and a full be ...
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The Curare Group Lancaster, United StatesHospital in southeastern Pennsylvania is seeking a Board Certified/Board Eligible Psychiatrist. You will join an experienced multi-disciplinary team while working in a state-of-the-art facility. Duties are exclusive inpatient for Adolescent and Adult patients. The region offers a ...
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Penn State Health Lancaster, United States Full timePenn State Health is seeking a BC/BE General Neurosurgeon to join our multidisciplinary team in the Lancaster-Berks region. The successful candidate will be based at Penn State's new Lancaster Medical Center and will direct neurosurgical services at this facility. This is an exci ...
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Penn State Health Lancaster, United States Full timePenn State Health Lancaster Medical Center is seeking a **General Neurologist for our brand new state of the art Lancaster Medical Center.** The new facility located in Lancaster, PA. Make your mark on this new facility set to open summer 2022. · - Neurologists with clinical expe ...
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Penn State Health Lancaster, United States Full timePenn State Health is seeking Board-certified/Board-eligible cardiologists to join our expanding program as a Non-Invasive Cardiologist. The ideal candidates will have clinical interests in non-invasive imaging (i.e., echo, cMR and CT) and experience in all facets of heart health ...
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Penn State Health Lancaster, United States Full time**Penn State Health Community Medical Group** is seeking an Infectious Disease physician. This is an exciting opportunity to join our team as we expand our services in Lancaster, Pennsylvania area. · **What We're Offering:** · - Competitive Salary · - Relocation Assistance · - Co ...
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The Curare Group San Francisco, United States PermanentMulti-specialty group with over 50 physicians in Philadelphia, PA is searching for a Board Eligible/Board Certified physician for their Primary Care opening. This position is 100% outpatient and offers the opportunity for partnership. Enjoy a competitive base salary and a full be ...
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Penn State Health Lancaster, United States Full time**Penn State Health Children's Heart Group** is seeking a dedicated **Outpatient Pediatric Cardiologist** who has the desire to **develop** a community-based practice that will align itself with local hospitals and neonatology practices, provide personalized services to pediatric ...
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Penn State Health Lancaster, United States Full time**Penn State Health Medical Group** is seeking a BC/BE **Family Medicine or Internal Medicine physician** to join our busy clinic located in beautiful Lancaster, PA that provides exceptional care to the patients in our community. · · Please contact Amber Winters at for additio ...
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Optum Lancaster, United States Full time**$40,000 Student Loan Repayment Or $10,000 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. · **Primary Responsibilit ...
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VocoVision Lancaster, United StatesJob Description · Job DescriptionMinimum 1+ years speech therapy experience required. · About Us:VocoVision, in partnership with Sunbelt, is a leading provider of telepractice services, connecting qualified professionals with schools in need of speech language pathology expertise ...
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Temporary Doctor Position- York, Pennsylvania
2 weeks ago
Heartland Dental York, United StatesReq ID: 87911 Supported Practice: West York Dental Care Category: General Dentist Location: 1623 Rodney Rd, York, PA 17408 · Work in an environment that encourages full clinical autonomy, balanced with the ability to tap into a robust mentor program and a network of more than 2,3 ...
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Clinical Lab Tech Positions in Pennsylvania
2 weeks ago
K.A. Recruiting, Inc. Loganville, United StatesClinical Lab Tech II and III permanent positions available just north of Loganville, PA Multiple shifts and days available · Details: · - Full time, permanent MT/MLT opening · - Full, comprehensive benefits package (PTO, health insurance, life insurance, 401k, etc) · - Many shift ...
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Family First Home Care Coatesville, United States Full time42 hours weekly. Female PT. · Schedule: · Monday 1pm-7pm (7hrs) · Tuesday-Thursday 9am-4pm (21hrs) · Friday 9am-1pm (4hrs) · **CLIENT IS A SMOKER** · ...
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Temporary Doctor Position- Hershey, Pennsylvania
4 weeks ago
Heartland Dental Hershey, United StatesReq ID: 88685 Supported Practice: Hershey Dental Group Category: General Dentist Location: 32 Northeast Dr Suite 202, Hershey, PA 17033 · Work in an environment that encourages full clinical autonomy, balanced with the ability to tap into a robust mentor program and a network of ...
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Clinical Lab Tech Positions in Pennsylvania
4 weeks ago
K.A. Recruiting Loganville, United StatesClinical Lab Tech II and III permanent positions available just north of Loganville, PA Multiple shifts and days available Details: - Full time, permanent MT/ MLT opening - Full, comprehensive benefits package (PTO, health insurance, life insurance Clinical, Tech, Lab, Lab, Healt ...
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Clinical Lab Tech Positions in Pennsylvania
2 weeks ago
KA Recruiting Inc. Loganville, PA, United StatesClinical Lab Tech II and III permanent positions available just north of Loganville, PA Multiple shifts and days available · Details: · Full time, permanent MT/MLT opening · Full, comprehensive benefits package (PTO, health insurance, life insurance, 401k, etc) · Many shi ...
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Penn State Health Hershey, United States Full time**The Penn State Health Milton S. Hershey Medical Center Department of Psychiatry** **and Behavioral Health** is currently recruiting board-eligible/certified **Psychiatrists** for inpatient, consultation-liaison and outpatient positions in **Adult, Child/Adolescent and Addiction ...
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Penn State Health Hershey, United States Full timeThe Department of Neurosurgery at Penn State Health and Penn State College of Medicine is seeking a highly skilled Spine Neurosurgeon with interest and expertise in spinal oncology to join the team at our flagship hospital, Penn State Hershey Medical Center (PSHMC) in Hershey, PA ...
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Fidelis Partners Lebanon, United States Full time**Nephrologist & Medical Director Role | Prestigious PA Practice | Near Urban · Hubs** · We are actively seeking a dedicated Nephrologist to join our esteemed team and · play a pivotal role in a well-established multi-specialty practice near · vibrant Pennsylvania communities. · ...
Emergency Medicine Full-Time position in Lancaster, Pennsylvania - Optum
Description
$40,000 Student Loan Repayment Or $10,000 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.
Primary Responsibilities:
Required Qualifications:
Preferred Qualifications:
