Mobile Nurse Practitioner - I-SNP

Mobile Nurse Practitioner – I‑SNP Company Information Company: Avail Health Medical Practice of Florida, P.A. Reports to: VP of Care Delivery, Katie Korte Location: Hybrid mobile role; must be located within Calverton, Maryland region or a reasonable commuting distance. About Avail Healthcare Avail Healthcare is a Nurse Practitioner‑founded organization dedicated to removing barriers to care for Medicare‑age individuals. We combine thoughtful technology, strong operational infrastructure, and deep respect for patient‑provider relationships to enable nurse‑led virtual and mobile care models. As a fast‑growing organization, we build durable clinical infrastructure to support innovative care programs across states, focusing on improving outcomes for complex and underserved senior populations. About the Role The Mobile Nurse Practitioner (NP) provides comprehensive, patient‑centered care to Institutional Special Needs Plan (I‑SNP) members residing in skilled nursing facilities (SNFs). This full‑time W‑2 position runs through December 2026, with possible extension based on performance. The NP works collaboratively with an interdisciplinary care team—including RNs, Care Coordinators, facility staff, and other healthcare professionals—to improve patient outcomes, reduce avoidable hospitalizations, and enhance quality of life while supporting efficient healthcare utilization. This is a highly collaborative, patient‑facing role requiring strong clinical judgment, effective communication, and the ability to translate clinical findings into actionable care plans. The NP will conduct Health Risk Assessments, develop individualized care plans, and coordinate ongoing member care, working independently in the field and continuously improving program development. Location & Work Environment The role is primary mobile/field‑based, requiring residence in Maryland. Candidates centrally located within the coverage area and able to support efficient daily travel are preferred. Standard hours: Monday‑Friday, 8:00 AM – 5:00 PM EST. Remote work requires a reliable high‑speed internet connection and a dedicated HIPAA‑compliant workspace. Key Responsibilities Deliver comprehensive primary and acute care services to I‑SNP members in SNFs, including initial, routine, and transition of care evaluations. Assess, diagnose, and manage acute illnesses, chronic conditions, and geriatric syndromes in a medically complex population. Develop, implement, and adjust individualized, goal‑oriented care plans with patients, families, and the interdisciplinary team. Order, interpret, and act on laboratory and diagnostic studies to guide clinical decision‑making. Prescribe medications and therapeutic interventions in accordance with regulatory standards and evidence‑based practices. Provide ongoing, proactive follow‑up to monitor clinical status, evaluate treatment effectiveness, and prevent avoidable complications or hospitalizations. Manage a dedicated panel of patients across custodial (long‑term care) settings. Oversee transitions of care—including admissions, readmissions, and discharges—to ensure continuity and quality of care. Collaborate with nursing staff, rehabilitation services, specialists, and facility leadership to coordinate and optimize patient care. Participate in interdisciplinary care plan meetings and contribute to comprehensive care planning. Recognize and respond to early signs of clinical deterioration with timely intervention. Provide patient, family, and caregiver education to support disease management, treatment adherence, and goals‑of‑care alignment. Deliver palliative and supportive care as appropriate, including advanced care planning and goals‑of‑care discussions. Maintain accurate, timely, and compliant documentation in the electronic medical record. Adhere to I‑SNP program requirements, quality metrics, and regulatory standards. What Success Looks Like Clinical Impact Delivers high‑quality, evidence‑based care, proactively identifying and managing clinical changes to reduce avoidable hospitalizations and ED visits. Effectively manages complex, high‑risk patients, improving stability, function, and quality of life. Panel & Care Management Maintains consistent visit cadence and ownership of assigned panel across SNF settings. Ensures seamless transitions of care with timely follow‑up and clear, actionable care plans. Collaboration & Communication Acts as a trusted clinical partner to facility staff and the interdisciplinary team. Communicates clearly with patients and families to support engagement and goals‑of‑care alignment. Operational Excellence Completes timely, accurate, and compliant documentation aligned with I‑SNP and Medicare Advantage requirements. Contributes to key quality metrics, including care gap closure and risk adjustment accuracy. Adaptability & Ownership Operates independently and efficiently in a mobile environment. Identifies opportunities to improve workflows and supports ongoing program growth. Qualifications Master’s or Doctoral degree in Nursing (MSN or DNP) from an accredited program. Current national certification as a Nurse Practitioner (FNP or Adult‑Gerontology NP). Active, unrestricted Maryland NP license in good standing. Active Maryland DEA registration with prescriptive authority, or willingness to obtain prior to start. 1‑3 years of clinical experience in geriatrics, long‑term care, institutional settings, mobile care, or value‑based care models. Experience managing medically complex or frail elderly populations. Familiarity with risk adjustment, HEDIS/STARs, and care transition best practices. Advanced clinical judgment with strong assessment and diagnostic skills. Comfort with remote work tools, EHR platforms, and technology‑enabled care delivery models. Strong communication, organizational, and documentation skills. Effective work in a hybrid environment with evolving workflows and processes. Residence in Maryland and ability to travel within assigned regions. Authorization to work in the United States. Compensation & Benefits Base Salary: $135,000‑$155,000 annually (dependent on experience and qualifications). 401(k) retirement plan with 2% employer match. Discretionary performance bonus based on individual performance and company metrics. Annual compensation review with potential adjustments. Mileage reimbursement: $0.725 per mile over 30 miles per day, up to $200 daily. Comprehensive benefits including medical, dental, vision, DPC model, and HSA contributions. Paid Time Off: 15 days annually, accruing per pay period. 8 paid holidays and 1 floating holiday per year. Additional Requirements Valid driver’s license, reliable transport, and active automobile insurance. Credentialing, privileging, and background check requirements. Compliance with all applicable federal, state, and organizational regulations governing clinical practice. Support & Resources Company provides necessary devices and professional liability coverage ($1M/$3M). #J-18808-Ljbffr