Physician Leader - Louisville or Lexington, KY
Company: UnitedHealth Group
Location: Lexington
Posted on: May 27, 2023
Job Description:
This is a Full-Time Opportunity
$30,000 Sign-on Bonus for external candidates
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)
Landmark Health 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.
Because many of our patients are frail and elderly, we deliver care
primarily in the comfort of their home. Our Program is also offered
to eligible patients at no incremental financial cost to them. We
are not a fee-for- service practice; we benefit economically only
if we deliver high-quality patient outcomes and satisfaction. As a
result, our clinical teams can spend quality-time caring for a
smaller number of patients, giving all patients the space, respect,
compassion and care they deserve.
At Landmark, our interdisciplinary teams collaboratively manage our
complex patient panels. These teams are led by Physicians, Nurse
Practitioners, and Physician Assistants, with supporting care
provided by RN Nurse Care Managers, Social Workers, Pharmacists,
Behavioral Health, and other employed team members.
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
Provides medical care and management to members served by Landmark
Health. Works with the Regional Medical Director, Director of
Health Services, Health Plan representatives, 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 existing
PCPs if present, the Landmark multi-disciplinary team, the health
plan Medical Director, and other health professionals, to develop
members' goals of care in all phases of longitudinal.
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 solid 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 assigned
Competency
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
- 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
- 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 workflow
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:
- Medical Doctorate or Doctorate of Osteopathy
- Current, valid, non-sanctioned, non-restricted license to
practice medicine in Kentucky
- Board Certified or Board Eligible in Internal Medicine,
Geriatrics sub-specialty or Family Practice
- Current Drug Enforcement Agency (DEA) license
- Ability to meet all Landmark Credentialing Requirements
- 2+ years of clinical experience
- Extensive experience in providing medical care to geriatrics
patients
- Knowledge of clinical standards of care
- Familiarity with Medicare Guidelines
- Familiarity with CPT and ICD-9 codes as related to billing
practices
- Malpractice profile meets Landmark's risk guidelines . click
apply for full job details
Keywords: UnitedHealth Group, Lexington , Physician Leader - Louisville or Lexington, KY, Healthcare , Lexington, Kentucky
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