Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)
Provides medical care and management to patients served by Homebased Medical Care (HbMC). Dedicated to improving the health and well-being of patients, this position collaborates with existing PCPs, the HbMC interdisciplinary team, and other health professionals, to develop and realize patients’ goals of care in all phases of longitudinal care.
- Day-to-day clinical leader of the interdisciplinary team, providing decision support to team patients providing care in the home to HbMC patients
- If there is no existing PCP recorded or currently practicing in the area or network, then the HbMC Physician Pod Leader will assume medical care duties of the PCP to provide care and continuity for the patient. HBMC will continue to work with the health plan and medical community to find and assign a PCP of record
- In situations where there is an existing PCP for the patient, the HbMC Physician helps to co-manage the patient with the PCP and functions as their extension into the home - the PCP’s eye and ears in the home
- Assess patients’ needs in their place of residence, including:
- Caregiver support
- Environmental safety
- Develop and update care plans and documentation of clinical encounters in the electronic medical record as per HbMC’s Medical Records Policies
- Provide same-day clinical assessment and treatment (urgent visits)
- On a rotational basis, provide after-hours medical coverage for assigned and covered patients
- Participates in clinical management meetings that include, but may not be limited to:
- Weekly case conference reviews
- Monthly staff meetings
- Scheduled Joint Operating Committee meetings
- Quarterly Quality Improvement Committee meetings
- Continuing education/journal club programs
- Provide medical care to a longitudinal panel of patients, including the following activities:
- Performs an initial comprehensive assessment on all newly enrolled patients and at least annually 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 in these meetings
- Calls and communicates directly with patient's PCP in real time to discuss any changes of condition and potential medication changes. Plans will be collaboratively decided on with PCP, but if unable to reach in an emergent situation, or PCP not responsive to collaboration request, the physician will render appropriate services and communicate changes at first available opportunity
- Completes follow-up and post-hospital assessments according to documented standard operating procedure
- Prescribes appropriate diagnostics and clinically appropriate interventions. o Consults with hospital physicians 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
- Addresses and documents advanced care planning and advanced directive wishes on initial visit and at least annually thereafter
- In addition to routine history and physical exam in the home, will be trained and be proficient at such modalities including, but not limited to:
- Insertion of IV
- Venipuncture for blood draw
- Wound care
- Dressing changes
- Catheter insertion and management
- Implements HEDIS measure campaigns and other quality initiatives as directed by Regional/Market Medical Director to ensure the highest standards of care and to promote the improvement of care management and delivery
- Keeps current on relevant medical research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
- Demonstrate appropriate medical judgment and appropriate use of resources with regards to care plans, diagnostic testing and referrals
- Develop solid patient-doctor and caretaker/family-doctor relationships to improve patient compliance with care plan
- Work with the patients of the interdisciplinary team to ensure care plan is meeting the clinical and psycho-social needs of the patient
- Provide timely, evidence-based and appropriate patient care at all times
- Complete and sign all documentation (including from vendors) within required timeframes
- Maintain high levels of patient and family satisfaction
- Arrange for transfers and placements to appropriate levels of care
- Perform other duties as assigned
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.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Medical Doctorate or Doctorate of Osteopathy
- Current, valid, non-sanctioned, non-restricted license to practice medicine in the state or multiple states corresponding with the needs of the assigned and covered patients
- Board Certified or Board Eligible with preference in Internal Medicine, Geriatrics or Palliative Medicine sub-specialty, Family Practice or Emergency Medicine
- Current DEA
- Ability to meet all HbMC Credentialing Requirements
- Extensive experience in providing medical care to geriatrics and/or seriously ill patients
- Familiarity with Medicare Guidelines
- Familiarity with CPT and ICD-10 codes as related to billing practices.
- Malpractice profile meets Optum’s risk guidelines
- 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 Optum Motor Vehicle Safety policy
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- 2+ years clinical experience, home-based care
- Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems
If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.