Advanced Practice Provider - Virtual Primary Care

Nurse Practitioner Monogram Health is looking for skilled Nurse Practitioners and Physician Assistants eager for the opportunity to make a difference in patients' lives. The Advanced Practitioner at Monogram Health is a key member of an integrated Care Team which includes a Registered Nurse and a Social Worker. The patients we serve often struggle with multiple serious diseases. Our Nurse Practitioners and Physician Assistants help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.

Your Impact Using your skills in this position will allow you to deliver personalized compassionate medical care to individuals mainly with CKD and/or ESRD/ESKD. Your gifts as a healthcare professional are urgently needed. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do.

Flexible scheduling with a hybrid and in-home mode

Value-based care, patient-focused and allows you to spend time with those in your care

Comprehensive medical, dental, vision and life insurance

Paid vacation and holiday time

Paid relocation assistance- location and case dependent

About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. Monogram Health is based in Nashville, Tennessee, operates throughout 37 states, and is privately held by Frist Cressey Ventures, Norwest Venture Partners, TPG Capital, as well as other leading strategic and financial investors. To learn more about Monogram Health, ranked by Inc. Magazine as 2024’s No. 3 fastest growing private company in the United States, please visit here .

Roles and Responsibilities Conducts assessments, which includes comprehensive annual wellness exams on patients both in the patients' home and in the virtual environment?

Counsels and educates patients and families about benefits and programs available to help them live healthier lives

Documents items such as: appropriate chief complaint, all applicable diagnosis, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment, and plan

Responsible for the coordination of care with primary care providers, specialists, and appropriate ancillary services

Maintains quality of care standards as defined by the practice

This position will not be office-based but will be remote in state in which employed and will need to attend periodic training/meetings outside of that state

Deliver evidence-based, timely care in a manner that reduces avoidable hospitalizations, maximizes quality of life, and puts patient health and satisfaction first

Perform effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily

Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing

Assists patients with enrolling to access educational videos

Participates in the integrated care team meetings

Make assessment of patient's health status

Implement a plan consistent with appropriate plan of care

Position Requirements Bilingual (English/Spanish) highly preferred

Active and unrestricted Registered Nurse and Nurse Practitioner or Physician Assistant license

Ability to work without direct supervision and practice autonomously

Access to transportation, a valid driver's license, and car insurance

Must be proficient with medical instruments and equipment required by the work

Knowledge of computer-based data management programs and information systems, as well as medical records and point-of-interview technology

Ability to communicate effectively in verbal and written form with retail and medical partners at various levels, patients, family members, physicians and representatives of the community?

2 or more years of direct patient care required

Managed Care/IPA/Health Plan experience