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Dedham

    Family Practice Full-Time position in Dedham, Massachusetts - Optum

    Optum
    Optum Dedham, United States

    3 weeks ago

    Optum background
    Full time
    Description

    $20,000 Sign On Bonus or $40,000 Student Loan Repayment for External Candidates


    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.


    Provides medical care and management to members served by the program and participates in gathering clinical information for medical necessity determinations for service requests.

    Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.

    Dedicated to improving the health and well-being of members, this position collaborates with the PCP, and as needed, the health plan Medical Director and other health professionals, to develop members' goals of care in all phases of long-term care.


    Required Qualifications:

    • Completion of accredited program
    • Licensed as NP in State where you will be practicing
    • Knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems
    • Knowledge of CPT, ICD-9 and HCPC codes
    • Knowledge of clinical standards of care
    • Access to reliable transportation required; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy

    Preferred Qualifications:

    • 2+ years clinical experience
    • Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems
    *

    Language Skills:
    Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public
    *

    Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

    Ability to compute rate, ratio, and percent
    *

    Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

    Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form


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