Nurse Practitioner Clinical Advisor - Senior Care - Eastern Virginia - Optum

Optum Home & Community Care is seeking a Nurse Practitioner Clinical Advisor to support Senior Community Care (SCC) teams providing integrated care to patients in nursing homes, senior housing, and assisted living settings. This role combines clinical practice with mentoring and leadership responsibilities, managing approximately 50% of a patient caseload while providing coaching and clinical guidance to Advanced Practice Clinicians (APCs) and Registered Nurses in the field.

Clinical Setting

You will work within Optum's Senior Community Care program, delivering care to patients across multiple long-term care and senior living environments. The role requires travel between care sites and may include after-hours on-call coverage.

Responsibilities

Clinical Leadership and Mentoring

• Set team direction, resolve problems, and provide guidance to team members
• Clinically mentor and teach APCs and RNs under the direction of the Clinical Services Manager (CSM), Clinical Team Lead (CTL), or Director of Clinical Operations (DCO)
• Partner with management to ensure effective onboarding of new clinicians and ongoing development of existing staff
• Develop innovative approaches and support implementation of new clinical and quality initiatives
• Oversee and implement clinical staff development programs in collaboration with market leadership
• Review work performed by others and provide recommendations for improvement
• Serve as a resource to APCs and RNs for escalated complex and clinical issues
• Communicate needs and issues surfaced by clinical staff to site and corporate leadership
• Promote development of a collegial team culture focused on clinical expertise
• Motivate and inspire team members

Clinical Care Delivery

• Maintain a caseload of 50% or more patients and acquire patients according to team needs
• Deliver cost-effective, quality care to assigned members
• Manage both medical and behavioral chronic and acute conditions in collaboration with physicians or specialty providers
• Perform comprehensive assessments and document findings in compliance with CMS regulations
• Ensure all diagnoses are accurate and support visit documentation
• Address and document all quality elements
• Conduct initial medication reviews, annual medication reviews, and post-hospitalization medication reconciliation
• Facilitate agreement and implementation of members' plans of care by engaging facility staff, families, and providers
• Evaluate effectiveness, necessity, and efficiency of care plans, making revisions as needed
• Utilize practice guidelines and protocols established by the organization

Care Coordination

• Understand payer/plan benefits and articulate them effectively to providers, members, and decision-makers
• Assess medical necessity and effectiveness of ancillary services
• Coordinate care as members transition through different levels of care and settings
• Monitor member and family needs and facilitate adjustments to care plans
• Review orders and interventions for appropriateness and treatment response
• Evaluate care plans for cost effectiveness while meeting member, family, and provider needs

Program Enhancement

• Communicate regularly and effectively with physicians, members, key decision-makers, nursing facilities, and provider groups
• Actively promote the program in assigned facilities by partnering with key stakeholders
• Demonstrate original thinking and creativity in developing new approaches to concerns and issues
• Function independently with minimal supervision
• Demonstrate initiative in achieving individual, team, and organizational goals
• Participate in quality initiatives

Additional Responsibilities

• Adapt departmental plans and priorities to address business and operational challenges
• Partner with clinicians and site functions to ensure business development activities meet business goals
• Serve as a knowledge-based expert resource
• May lead functional or segment teams and projects
• Provide explanations and information to others on complex issues
• Solve complex problems and develop innovative solutions in collaboration with stakeholders
• Perform complex conceptual analyses
• Forecast and plan resource requirements
• Authorize deviations from standards

Required Qualifications

• Certified Nurse Practitioner through a national board with a graduate degree (MSN or DNP) from an accredited program
• Board certification through AANP or ANCC in one of the following: Adult-Gerontology Acute Care Nurse Practitioner (AG AC NP), Adult/Family Nurse Practitioner (ACNP), or Gerontology Nurse Practitioner (GNP). Preferred certifications are ANP, FNP, or GNP.
• Active and unrestricted nursing license in your state of residence
• Current active DEA licensure and prescriptive authority, or ability to obtain post-hire per state regulations (unless prohibited in your state)
• Minimum 1 year of experience as an APC at Optum
• Access to reliable transportation to travel to client and patient sites within a designated area
• Ability to move a 30-pound bag in and out of a car and navigate stairs and various dwelling conditions and configurations
• Ability to gain a collaborative practice agreement if applicable in your state

Preferred Qualifications

• 2 or more years of experience as an APC
• 1 or more years of Medicare experience
• Experience in adult teaching environments
• Ability to develop and maintain positive customer relationships
• Knowledge and understanding of geriatric clinical management
• Ability to work across functions and businesses to achieve business goals
• Effectiveness in motivating and mentoring colleagues and peers
• Ability to quickly adapt to change and drive change management within team and market
• High level of organizational skills, self-motivation, and ability to manage time independently
• Proficient computer skills including ability to document medical information with written and electronic medical records
• Basic Excel skills or ability to learn Excel

Compensation and Benefits

Compensation for this specialty generally ranges from $115,000 to $172,000. Total cash compensation includes base pay and bonus and is based on several factors including local labor markets, education, work experience, and may increase over time based on productivity and performance in the role.

Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements).

Travel Requirements

Travel between care sites is mandatory. You must have access to reliable transportation and the ability to navigate various dwelling conditions and configurations.