Family Practice / Primary Care Nurse Practitioner

The Community-Based Provider (CBP) sees patients in their home. The CBP primarily does in-home medical assessments, and ensures they are engaged in active primary care. This position adds to a member s current care, collaborating with their current care providers. The role is immensely satisfying, as you develop a deep understanding of our patients needs, and are able to engage a robust care team to address them. Seeing members in the home allows you great insight into the social factors that affect their care. This is a tremendous opportunity to impact the care of vulnerable patients.

This position is paid per completed visit. It enables providers to have a flexible work schedule.

Duties and Responsibilities

Provide community-based medical care and care-coordination :

• In-Home Assessments (IHA) : Conduct comprehensive in-home assessments for patients, including medical history reviews, physical examinations, and medication management.
• Patient Assessment : Conduct thorough assessments of patients' health status, including physical examinations, medical histories, and risk assessments.
• Work collaboratively with physicians, case managers, social workers, family members, key caregivers and any appropriate ancillary medical personnel as appropriate
• Collaborate with Primary Care Physician (PCP) on patient education, provide follow-up
• Provide services in a variety of venues to include : Home Visits, Skilled Facility Visits, and Telehealth Visits
• Help patients identify barriers to meeting health and life goals and connect patients with resources to navigate barriers.
• Educate and coach for medication adherence and chronic disease self-management skill development.
• Monitor members at risk of being lost to care and implement interventions to prevent loss.

Check you match the skill requirements for this role, as well as associated experience, then apply with your CV below.