Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider

Schedule Full‑time, 5‑day, 8‑hour position (8:30 AM – 5:00 PM CST/MST/PST). Candidates must consistently work within Central, Mountain, or Pacific time zone hours. Overview As a Devoted Medical Transitions of Care (TOC) Advanced Practice Provider (APP), you will help build the program and provide virtual care during the 30‑day window after a patient is discharged. The goal is to prevent readmissions through comprehensive, wrap‑around care delivered by a highly interdisciplinary team. Responsibilities and Impact Perform comprehensive initial TOC visits, conducting a thorough post‑discharge assessment of medical conditions, medications, functional status, and psychosocial needs. Complete post‑discharge medication reconciliation, identify duplicate, inappropriate, or contraindicated therapy, and optimize guideline‑directed medical therapy. Place appropriate orders (prescriptions, labs, imaging, referrals, home health, durable medical equipment), provide disease‑specific education, and communicate clear contingency plans and red flags for worsening symptoms. Conduct acute/virtual urgent‑care TOC visits, independently assessing, diagnosing, and managing new or worsening symptoms in medically complex patients. Manage the clinical trajectory across the 30‑day window, reinforcing and adjusting each patient’s plan of care in response to evolving clinical picture, priorities, and barriers. Participate in interdisciplinary TOC rounds, collaborating closely with RN case managers, care coordinators, social work case managers, pharmacy, and patients’ primary care providers and specialists. Enhance team culture by facilitating safe, open communication across roles and supporting clear patient escalations. Assist with clinical education of the broader team, participate in quality‑improvement projects and pilots, and provide feedback to improve the EHR. Adapt to evolving clinical and organizational initiatives as the service grows. Required Skills and Experience 5+ years of direct patient care managing primarily geriatric populations with multiple chronic, complex, comorbid conditions across acute and chronic presentations. Demonstrated comfort managing the continuum of care: acute management of chronic illness and longitudinal outpatient chronic‑disease management. Strong, independent clinical decision‑making and bias to action in a virtual setting. Proficiency with complex medication reconciliation and guideline‑directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension. Comfort diagnosing, managing, and monitoring decompensating patients with high‑readmission conditions such as heart failure, COPD, diabetes, hypertension, pneumonia, cellulitis, and urinary tract infections. Ability to work the full‑time 5‑day, 8‑hour schedule (Monday‑Friday 8:30 AM – 5:00 PM within CST/PST/MST hours). Strong team player who thrives in an interdisciplinary environment. Proficiency in English and Spanish required. Desired Skills and Experience Experience in internal medicine, hospital medicine, post‑acute/SNF medicine, urgent care or emergency medicine, geriatrics, palliative care, and/or primary care with a strong chronic disease management focus. Experience managing acute and chronic disease exacerbations, including CHF, COPD, diabetic emergencies, and hypertensive emergencies, and identifying the need for immediate intervention. Experience performing visits over telehealth video platforms. Experience working with frail, complex, or vulnerable populations, including in the skilled nursing facility (SNF) setting. Continuous‑improvement mentality, can‑do attitude, and ability to adapt quickly to new workflows and changes. Licensure and Certification For Nurse Practitioners: active and in‑good‑standing RN and APRN licenses. For Physician Assistants: an active and in‑good‑standing Physician Assistant license. Licensure and good standing required in existing or future Devoted states; able and willing to obtain required state licenses within 60‑90 days of hire. States FL, TX, AZ, OH, and/or GA required to start. Salary Base salary $120,000‑$150,000 per year plus performance‑based bonus ($10,000‑$20,000) for a total compensation range of $130,000‑$170,000 per year. The actual base salary offered will depend on qualifications, experience, education, certifications, and location. Benefits Employer‑sponsored health, dental, and vision plans with low or no premium. Generous paid time off. $100 monthly mobile or internet stipend. Stock options for all employees. Bonus eligibility for all roles (excluding Director and above). Commission eligibility for sales roles. Parental leave program. 401(k) program. Equal Opportunity Employer Statement Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. #J-18808-Ljbffr Devoted Health, Inc.