Optum Clinical Review Jobs (NOW HIRING)

Optum Home & Community Care, part of the Optum 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) team, we work to provide care to patients in nursing homes, senior housing and assisted living settings. 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 settings. Join us to start Caring. Connecting. Growing together.

The Clinical Advisor is responsible for managing up to approximately one half a case load and for providing mentoring, coaching and support for APCs and RNs in the field. The Clinical Advisor partners with their Clinical Services Manager (CSM), Clinical Team Lead (CTL) or Director of Clinical Operations (DCO) to enhance clinical expertise and adherence to Optum's clinical model.

Primary Responsibilities:

• Set team direction, resolve problems, and provide guidance to members of own team
• Adapt departmental plans and priorities to address business and operational challenges
• Clinically mentor/teach team members as appropriate under the direction of CSM
• Maintain caseload of 50% or more patients and acquire patients according to team needs in conjunction with clinical advisor duties
• The CA reports to and is supported by the CSM, CTL, or DCO
• Partner with the manager or supervisor to ensure effective on-boarding of new clinicians and ongoing development of existing clinicians
• Develop innovative approaches and support the implementation and adoption of new clinical and quality initiatives
• Does not have direct reports but works in coordination with the CTL, CSM, and/or DCO to enhance clinical expertise and adherence to the clinical model through planning and implementing the orientation and development of APC staff
• Utilize advanced clinical nursing expertise, knowledge of geriatric/chronic disease management, and the long-term care industry to provide coaching, mentoring, and role-modeling to new and existing clinicians
• Oversee and implement clinical staff development programs in collaboration with market leadership
• Review work performed by others and provides recommendations for improvement in conjunction with supervisor
• Serve as a resource to APCs/RNs for escalated complex and/or clinical issues
• Partner with clinicians and other site functions to ensure business development activities are in place to meet business goals
• Sought out as knowledge-based expert
• Communicate needs and issues surfaced by clinical staff to site and corporate leadership
• Serve as a leader/ mentor
• Promote the development of a collegial team, for coverage, troubleshooting and brainstorming
• Foster and develop a culture of clinical expertise
• Anticipate customer needs and proactively develop solutions to meet them
• Solve complex problems and develop innovative solutions in collaboration with other stakeholders
• Perform complex conceptual analyses
• Forecast and plan resource requirements
• Authorize deviations from standards
• May lead functional or segment teams and/or projects
• Provide explanations and information to others on complex issues
• Motivate and inspire other team members

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
• 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)
• 1+ years of experience as an APC at Optum
• Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
• Ability to move a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations
• Ability to gain a collaborative practice agreement, if applicable in your state

Preferred Qualifications:

• 2+ years of experience as an APC
• 1+ years Medicare experience
• Experience in adult teaching environment
• Ability to develop and maintain positive customer relationships
• Possess knowledge and understanding of geriatrics clinical management
• Ability to work across functions and businesses to achieve business goals
• Effective in motivating and mentoring colleagues and peers
• Able to quickly adapt to change and drive change management within team and market
• Possess a high level of organizational skills, self- motivation, and ability to manage time independently
• Proficient computer skills including the ability to document medical information with written and electronic medical records
• Basic excel skills and/or ability to learn excel

Compensation for this specialty generally ranges from $115,000 - $172,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.