Nurse Practitioner PruittHealth D-SNP

Job Description - Nurse Practitioner PruittHealth D-SNP (2611937)

Description

JOB PURPOSE: In collaboration and consultation with physicians, staff RN's and other health care professionals, provides holistic, compassionate care to patients and families and provides care coordination and care management activities on behalf of the PruittHealth Premier Plan. Practices within the context of collaborative management with the physician(s) in diagnosing, managing, and preventing acute and chronic illness and disease, and promoting wellness. D-SNP Nurse Practitioners will visit members in their home as well as conduct telehealth visits for health risk assessments for new and post care transition members. Nurse Practitioners haveanadvancednursing practice that includes independent nursing functionsbasedonnursingstandardsofcareandaroleinmedicalmanagementworkingwithinacollaborative agreement with a physician(s).

KEY RESPONSIBILITIES

• 1. Proven ability to perform comprehensive, adult/geriatric admission history and physicalexam
• 2. Demonstrates ability to identify, diagnose and document episodic, acute and chronic disease inadults
• 3. Demonstrates ability to recognize conditions, characteristics, and behaviors that place seniors atrisk
• 4. Proven ability to pursue feedback, continuing education and professionaldevelopment
• 5. Ability to effectively reconcilemedications
• 6. Demonstrates ability to identify and document the needs of clinically complexpatients
• 7. Work collaboratively with physicians, case managers, social workers, family members, key care givers and any appropriate ancillary medical personnel asappropriate
• 8. Participates in Quality Assurance Performance Improvement (QAPI)activities
• 9. Assesses the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate teammembers
• 10. Coordinates care as member's transition through different levels of care and care settings, ensuresthatthe ICP is communicated immediately and/or no later than 24 hours to the receiving care setting

QUALIFICATIONS

MINIMUM EDUCATION REQUIRED

Graduate of an accredited Adult or Family Nurse Practitioner Master’s Degree program or Physician Assistant Studies

MINIMUM EXPERIENCE REQUIRED

Minimum 2 years clinical experience as a Nurse Practitioner or Physician Assistant in geriatric, adult or family practice setting. Proven ability to perform comprehensiveadult/geriatric physical exams.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW

• Current and unrestricted, RN and NP licensure, or PA licensure in state of practice. Board certification by AANP or ANCC, in Adult, Family Practice and Geriatrics or Adult-Gerontology Primary Care. Current CPR certification
• Must have an active national provider number (NPI) and an active Medicare provider number
• Must be eligible to participate in the Medicare program as a provider and registered

ADDITIONAL QUALIFICATIONS: (Preferred qualifications)

Graduate of an accredited Geriatric, Adult or Family Nurse Practitioner Master’s Degree program. Previous experience visiting clients in their homes preferred.

KNOWLEDGE, SKILLS, ABILITIES

• 1. Pertinent Clinical Work Experience which is relevant to population beingserved.
• 2. Reviews and interprets the medical and social history ofmembers
• 3. Interprets laboratory data, recommend appropriate follow-up, reconcilemedications
• 4. Manages both medical and behavioral chronic and acute conditions effectively in collaboration with a physician or specialtyprovider
• 5. Synthesizes information and easily diagnoses and creates a comprehensive plan ofcare.
• 6. Complete all regulatory required monthly, quarterly, and/or annual visits and acute visits as needed.
• 7. Maintain appropriate and compliant documentation within our EMR (electronic medical record) software
• 8. EnsuresalldiagnosesareICD-10codedaccuratelyanddocumentedappropriatelytosupportthe diagnosis at thatvisit
• 9. Reviewsordersandinterventionsforappropriatenessandresponsetotreatmenttoidentifythemosteffective plan of care that aligns with the member's needs andwishes
• 10. Participate in family conferences and provide advanced care planning and education when needed
• 11. Address any pharmacy recommendations or pharmacist communications regarding members
• 12. Work together with the care management team to communicate issues identified to care management for follow up and to meet HEDIS/Star Quality measures
• 13. Practice ethically and in accordance with the Scope and Standards of Practice of their profession and Board Certification