Nurse Practitioner

Job Description

Job Description

The primary role of the Nurse Practitioner (NP) is to manage care for an assigned caseload of enrollees with the enrollees PCP as well as the entire interdisciplinary care team (ICT). This includes physical assessments, contact with the Utilization Management department, entering notes into an Electronic Health Record and recording data on quality indicators while adhering to the CMS / State guidelines pertaining to institutional care and services for the frail and elderly populations.

TASKS :

• Conduct an initial assessment of new enrollee’s by reviewing case files, meeting with the beneficiaries, their representatives, and facility staff. This collaborative effort includes obtaining information from physicians or other medical personnel.
• Assistance in the development and ongoing modification of an individualized care plan (ICP).
• Meet and maintain partner facility’s specific credentialing requirements.
• At times could be asked to conduct a Health Risk Assessment Tool (HRAT) per company guidelines and policy.
• Visit each assigned enrollee on a routine monthly / bi-monthly basis on more frequently based on acuity according to the enrollee’s vulnerability (for example those with recent hospitalization and those with skin issues should be seen weekly). Visits may be at the nursing / adult home facility, or other venue.
• Review and record the results of each visit and / or other required documentation for each beneficiary in EHR within specified timeframes of evaluation, unless unavoidable circumstances are noted.
• Discuss and document any problems or concerns of the enrollee with them and / or other members of the ICT.
• Identify changes in health and report to the appropriate medical personnel.
• Contact and maintain communication with enrollee, representative on routine or more frequent basis based on FCNY guidelines.
• Communicate regularly with the enrollee’s PCP based on the PCP’s preferences as documented in the Physician Agreement and as specified in the Model of Care. This includes documentation in the enrollee’s electronic record per company guidelines.
• Cover other facilities at the request of management.
• Completion of root cause analysis of transitions per company guidelines.
• Communicate with PCP’s in facilities assigned to and if covering another facility per the PCP Communication Agreement.
• Communication of enrollee’s acuity / status to UM department when noted or when outreach by UM staff occurs.
• Accept on-call responsibilities and make “after-hours” visits to acute enrollee’s as needed when on-call.
• Complete all required visits, forms and documentation in a timely manner per guidelines and company policy.
• Attend required meetings as identified by the Clinical Team Management Staff, Medical Director and / or COO of FCNY.
• Ensure that Model of Care expectations are understood and that expectations are followed for all beneficiaries.
• Quality Documentation that reflects clinical picture of enrollee’s including past medical history and accurate diagnoses ensuring that ICD10 codes are being utilized and are fully supported in the documentation.
• Conduct informal facility staff education and teaching to improve the effectiveness and efficiency of care delivery if and when requested by Clinical / Operations team. This may include Model of Care training.
• Perform all related duties, as assigned.
• Other duties as assigned.

EDUCATION : Applicable license in the State of New York

EXPERIENCE :

ABILITIES :

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, age, or national origin.