Care Home Matron

Nurse Practitioner

Duo Health is a new type of medical group designed around the needs of patients with chronic kidney disease and their physicians. Our unique Health Mobilization™ platform partners multidisciplinary care teams with community nephrologists and activates all the other clinicians, facilities and community organizations necessary to treat the whole patient on their own terms. Our team is comprised of leaders in value-based health care, technology and behavioral science who share a vision for advancing health equity one relationship at a time. Our interprofessional care teams, which include physicians, nurses, social workers, and patient navigators, provide high-touch and comprehensive care to a small panel of patients. Team collaboration is essential to our intensive, psycho-social model of care which includes assessment, medication management, social management, and behavioral health management. Duo Health is dedicated to ensuring our staff reflects the diversity of our patient population and applicants whose work demonstrates a commitment to issues of diversity are encouraged to apply.

The Nurse Practitioner will act as part of a care team that directly interfaces with a small panel of patients with CKD stages 3b, 4, 5, and ESRD in order to drive high quality value-based care. He/she will interact with and evaluate patients in the home, via teleconference, or via telephone as appropriate. In this role, the NP will create close working relationships with the patients served and with the care team members. Every day will entail contact with care team members and patients to coordinate optimal care for the patient panel. Location: This role provides in-home care across the Fort Lauderdale area. Nurse Practitioners operate as part of a care team and travel to patient residences. This is not an office-based or clinic-based position. Monday–Friday, 8:00 am–5:00 pm

Assume medical responsibility for an assigned small panel of patients in collaboration with care team; provide clinical services focused on patient level interventions and system level interventions (both medical and kidney-focused).

Identify and manage patients' medical conditions and obstacles to care.

Participate in frequent care team huddles.

Educate patients and caregivers about medical conditions and treatment plans.

Determine the need for consultation from medical, surgical, and/or psychiatric specialties.

Facilitate care across a variety of settings, including emergency department, hospital, skilled nursing facility, home health agency, hospice, and/or community-based organizations as appropriate.

Perform structured assessments and develop and implement comprehensive care plans for the patient panel.

Document all medical encounters accurately and in a timely manner.

Assist in the development and implementation of clinical protocols and guidelines of care in order to optimize outcomes.

Support company efforts of continuous quality improvement.

Adhere to all company policies and procedures.

Licensed Advanced Practice Nurse (APN) in the state of Florida.

Must meet Duo Health clinician credentialing criteria, including passing a background check

Must be able to travel to patient homes.

Experience working with community resources from diverse backgrounds

Ability to communicate effectively both orally and in writing.

Must be comfortable interacting with patients and care teams both telephonically and in-person.

Competitive medical, dental and vision plans

• Adoption Assistance
• Access to free wellness & personal development courses
• Paid holidays and 4 weeks PTO
• A mission-driven approach to each and everything that we do, with an overall goal to improve health equity and health outcomes.