Family Nurse Practitioner

Job Summary

The Care Connections NPs focus on screening and preventive primary care services delivered in the home, community and nursing facility settings.

Provides needed care in the environment that patients feel most comfortable and are most receptive including home, nursing facilities, and pop up clinic.

The Nurse Practitioner will be required to work primarily in non-clinical settings and provide medical care to all levels of patients.

Some programs may focus on specific populations (e.g., adult and geriatric, pediatric, women's health).

Perform comprehensive medical assessments, order appropriate tests / procedures for diagnostic purposes, formulate treatment plans, obtain specialists' consultations as needed, and do appropriate documentations as required.

Job roles and responsibilities emphasize a team-based approach to care and support each member of the team being trained to meet the highest level of function allowed by state law.

Knowledge / Skills / Abilities

Duties and Responsibilities (List all essential duties and responsibilities in order of importance)

• Provide general medical care to various and / or specific patient levels adults, geriatrics and pediatrics.
• Perform comprehensive evaluations including history and physical exams for risk adjustment and other regulatory assessments
• Address both chronic and acute primary care complaints, and able to ascertain medical urgency
• Establish and document reasonable medical diagnoses
• Seek specialty consultation as appropriate
• Order pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptom; able to work within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately
• Discuss unusual or unclear symptoms or results with consulting physician in a timely manner
• Accept feedback and direction from the supervising physician
• Create and implements a medical plan of care
• Provides care coordination and preventative care services for geographical as well as virtual targets who are stratified by risk.
• Schedule patient appointments for telehealth or in-person visits when appropriate
• Provide post discharge coordination to reduce hospital readmission rates and emergency room utilization
• Perform face-to-face in-person visits in a variety of settings including home, skilled nursing facilities, and public locations.
• Additionally, perform face-to-face synchronous video communications using Tele-Health platform based on business need and leadership direction
• Order bulk laboratory orders to target specific populations of member.
• Perform alternating on-call coverage to triage any urgent lab results and develop appropriate plan of care
• Participate in community-based Pop Up Clinics as way of building relationship with community while addressing gaps in health care
• Collaborate with fellow nurse practitioners to develop best practices to efficiently and effectively carry out work duties
• Actively participate in regional meetings
• Prescribe medications as appropriate
• Remain knowledgeable on current therapies
• Perform timely documentation in medical records in an electronic medical record computer system
• Engage in practices constituting the practice of medicine in collaboration with and under the medical direction and supervision of a licensed physician to the degree required by state laws.

May also function as and perform all duties reasonably expected and assigned to an RN such medication administration.

• Work as a partner with supervising physician. The NP is responsible for initiating collaboration, as it is needed.
• The NP is responsible for knowing when a patient needs physician oversight and when the patient's medical condition may be beyond the scope of knowledge of the NP.

Job Qualifications

Required Education

Master's degree in family health from accredited nursing program