Nurse Practitioner or Physician Assistant
JOB PURPOSE\:
In collaboration and consultation with physicians, staff RN's and other health care professionals, provides holistic, compassionate care to patients and families and provides care coordination and care management activities on behalf of the PruittHealth Premier Plan. Practices within the context of collaborative management with the physician(s) in diagnosing, managing, and preventing acute and chronic illness and disease, and promoting wellness. Nurse Practitioners have an advanced nursing practice that includes independent nursing functions based on nursing standards of care and a role in medical management working within a collaborative agreement with a physician(s).
KEY RESPONSIBILITIES\:
1. Proven ability to perform comprehensive, adult/geriatric physical exam
2. Demonstrates ability to identify, diagnose and document chronic disease in adults
3. Demonstrates ability to recognize conditions, characteristics, and behaviors that place seniors at risk
4. Proven ability to pursue feedback, continuing education and professional development
5. Ability to effectively reconcile medications
6. Demonstrates ability to identify and document the needs of clinically complex patients
7. Work collaboratively with physicians, case managers, social workers, family members, key care givers and any appropriate ancillary medical personnel as appropriate
8. Participates in and/or directs Quality Assurance Performance Improvement (QAPI) activities
9. Understands the PruittHealth Premier Plan benefits, PruittHealth Premier Plan policies, procedures and articulate them effectively to providers, members and key decision-makers
10. Assesses the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate team members
11. Coordinates care as member's transition through different levels of care and care settings, ensures that the ICP is communicated immediately and/or no later than 24 hours to the receiving care setting
12. Establishes schedule according to approved PHP nurse practitioner workflow
13. Establishes and documents visit schedule according the HRA stratification (low, moderate, high)
14. Ensures all Members have an ICP developed within 48 hours of HRAT
15. Facilitates agreement and implementation of the member's plan of care by engaging beneficiary, the facility staff, families/responsible parties, primary and specialty care physicians
16. Evaluates the effectiveness, necessity and efficiency of the plan, making revisions as needed
17. Utilizes practice guidelines and protocols established by PruittHealth Premier Plan