Physician - POD Leader - Durham, NC

Company: UnitedHealth Group
Location: Durham
Posted on: May 16, 2022

Job Description:

Landmark Health, part of the Optum and UnitedHealth Group family of businesses, was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are ill-equipped to navigate our overwhelming healthcare system.Join Landmark to be part of a growing company full of purpose-driven, action-oriented, and compassionate team members working to dramatically transform healthcare for our communities.ObjectiveProvides 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.Primary Responsibilities:

• Functions as the day to day clinical leader of the multi-disciplinary team, providing decision support to team members providing care in the home to Landmark patients
• In situations where there is no existing PCP for the patient, the Landmark Physician will assume responsibility as PCP to drive care and continuity for this patient
• In situations where there is an existing PCP for the patient, the Landmark 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:
  • Medical
  • Social
  • Psychological
  • Financial
  • Caregiver support
  • Environmental safety
  • Provide 24/7 medical coverage for assigned and covered patients (this can be as part of a call schedule).
  • Develop and update care plans and documentation of clinical encounters in the electronic medical record as per Landmark's Medical Records Policies
  • Provide same-day clinical assessment and treatment for pre-crisis intervention
  • Participates in management meetings that include, but may not be limited to:
    • Weekly case conference reviews
    • Monthly staff meetings
    • Schedule Joint Operating Committee meetings
    • Quarterly Quality Improvement Committee meetings
    • Continuing education/journal club programs
    • Performs an initial comprehensive assessment on all newly enrolled members and at least annually thereafter. Develops a member management care plan upon enrollment and updates it as needed when changes in condition warrant or following hospitalization. Meets with members 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 and emergent situation, NP/PA 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 interventions to avoid unnecessary transfers/acute admissions
    • Consults with hospital physicians following notification of member transfer
    • Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
    • Educates members and/or their legal representatives in disease processes affecting members 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
    • Implements HEDIS measure campaigns and other quality initiatives as directed by Regional Medical Director to ensure the highest standards of care and to promote the improvement of care management and delivery
    • Routine caseload during business hours and scheduled on call after hours / weekends with possibility of home visits for crisis interventions
    • Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
    • 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
      • Demonstrate appropriate medical judgment and appropriate use of resources with regards to care plans, diagnostic testing and referrals
      • Develop strong patient-doctor and caretaker/family-doctor relationships so as to improve patient compliance with care plan
      • Work with the NCM 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 assignedCompetency:To perform the job successfully, an individual should demonstrate the following competencies:
        • Problem Solving -- Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics
        • Technical Skills -- Assesses own strengths and weaknesses; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others
        • Customer Service -- Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments
        • Interpersonal Skills -- Focuses on solving conflict; maintains confidentiality; listens to others; keeps emotions under control and overcomes resistance when necessary; remains open to new ideas
        • Oral Communication -- Speaks clearly and persuasively in positive or negative situations; listens and seeks clarification; responds openly to questions. Must be able to deal with frequent change, delays, or unexpected events
        • Attendance/Punctuality -- Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time
        • Dependability -- Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan
        • Initiative -- Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed; generates suggestions for improving work and workflowYou'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: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.
          • Certificates, Licenses, Registrations:
            • Medical Doctorate or Doctorate of Osteopathy -
            • Board Certified or Board Eligible in Internal Medicine, Geriatrics sub-specialty or Family Practice
            • Current DEA
            • 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
            • Education and/or Experience:
              • Current, valid, non-sanctioned, non-restricted license to practice medicine in the state
              • Board Certified in Internal Medicine, Geriatrics sub-specialty or Family Practice [Board Eligible for up to one year if new grad
              • 2+ years clinical experience, home-based care -
              • Extensive experience in providing medical care to geriatrics patients
              • Familiarity with Medicare Guidelines
              • Familiarity with CPT and ICD-9 codes as related to billing practices
              • Knowledge of clinical standards of care
              • Ability to meet all Landmark Credentialing Requirements
              • Malpractice profile meets Landmark's risk guidelines
              • Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful
              • Full COVID-19 vaccination is an essential requirement 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 compliancePhysical Demands:Below are the physical requirements which are representative of those that must be met by the employee to -successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
                • Regular requirement to sit; use hands to touch, handle or feel
                • Regular requirement to talk and listen
                • Occasional requirement to stand; walk and reach with hands and arms
                • Occasional requirement to lift and/or move up to 10 pounds
                • Vision abilities include close vision, peripheral vision, depth perception and ability to adjust focus
                • Ability to travel by plane or carWork Environment:Below is a description of the work environment that the employee will encounter while performing the essential functions of the job
                  • Noise level is usually moderateTo 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 employmentAbout OptumCare:At OptumCare, we've found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving over 17 million people through more than 45,000 aligned physicians and 9,000 advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more at www.workatoptum.com.Would you thrive with OptumCare?
                    • Do you practice evidence-based medicine?
                    • Are you seeking a practice focused on patient-centered quality care, not volume?
                    • Are you a team player - comfortable delegating and empowering teams?
                    • Are you constantly seeking better ways to do things?
                    • Do you want to be part of something better?Careers with Optum. -Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do -your life's best work.(sm)*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.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 bylower 48 law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Durham , Physician - POD Leader - Durham, NC, Healthcare , Durham, North Carolina