This position will have a county territory coverage including Erie, Crawford, Mercer, Venango, Clarion, Forest and Warren Counties, PA. 

Serving millions of Medicare and Medicaid patients, Optum is the nation’s largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family. We’re also the career home for Nurse Practitioners who bring compassion and passion, energy and focus to their work every day.  As a Home Visit Nurse Practitioner with Optum, you’ll provide primary care home visits for patients in collaboration with the physician of record and patient care team. This position is serving throughout the Northwestern PA area.

The Optum Dual Special Needs Plan (DSNP) at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members in their place of residence. The DSNP program combines Optum trained clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team, which includes the Optum clinician, the member’s Primary Care Provider and other providers, and other professionals.

After conducting an initial comprehensive patient assessment, you will communicate and manage the patients’ plan of care across all care providers, family, and caregivers to ensure that timely, patient-centered, appropriate evidence - based medicine is provided. By building strong relationships, you’ll have a meaningful impact on the patient’s health as you collaborate with the care team to provide direct patient care and develop a plan of care to achieve patient’s goal and clinical outcomes.

Primary Responsibilities:

• Obtain and review medical history, conduct physical and psychosocial assessments, analyze and diagnose conditions and develop appropriate plan of care
• Identify gaps in care, interpret diagnostic test and reports and refer appropriately
• Identify risk factors and help mitigate barriers to access care and reduce risk
• Develop interventions to assist members in attaining established goals of care
• Evaluate member’s progress in completion of goals of care and re - assess and assist in care management with members

• Serves as a key resource on complex and / or critical issues

• Solves complex problems and develops innovative solutions

• Establishes and maintains communication and a trusting relationship with the member, family/authorized representative and primary caregiver and specialists

• Discuss medical options / interventions with members/families to promote understanding and assist them in making informed decisions

• Clarify member's cultural values that may impact health management / decisions

• Identify prognosis/trajectory of chronic disease that may impact future member health decisions and conduct advanced care planning discussions

• 100% travel in local market area to patient’s homes for in home visits