Advanced Nurse Practitioner

Complex Care • Pasadena, TX

1d • Hybrid

About The Position

Connected Healthcare Partners (CHP) is redefining healthcare delivery by bringing high-acuity medical services directly into patients' homes throughout the Greater Houston area. Our integrated model combines mobile acute care, transitional care management, chronic disease management, and nurse-supported telehealth services to deliver timely, high-quality care in the environment where patients often recover best — their own homes. Our mission is simple: close the gap between hospital discharge and durable recovery by reducing unnecessary emergency department utilization, preventing avoidable readmissions, and improving continuity of care for medically complex patients.

Requirements

• Active and unrestricted Texas licensure as a Family Nurse Practitioner (FNP).
• Master of Science in Nursing (MSN) from an accredited institution.
• Active Texas prescriptive authority.
• Current BLS certification.
• Valid driver's license and ability to travel throughout the Greater Houston area.
• Ability to lift and transport up to 50 pounds of clinical equipment and supplies.
• Ability to safely navigate stairs and varying home environments.
• Comfortable practicing independently in non-traditional, home-based settings.

Nice To Haves

• Emergency Nurse Practitioner certification (ENP-C) in addition to FNP certification.
• Active DEA registration.
• Current ACLS certification.
• Two or more years of experience in emergency medicine, urgent care, mobile acute care, hospital medicine, or high-acuity outpatient settings.
• Experience in transitional care management, home-based primary care, or post-acute care services.
• Experience conducting telehealth visits and remote patient assessments.
• Familiarity with CLIA-waived testing requirements and laboratory compliance standards.
• Multistate licensure or willingness to obtain additional licenses to support future telehealth expansion.

Responsibilities

• Perform comprehensive history and physical examinations in patients' homes across a broad range of acute and urgent presentations.
• Develop differential diagnoses and initiate evidence-based treatment plans for acute illnesses and injuries.
• Administer intravenous fluids and medications as clinically indicated.
• Perform and interpret CLIA-waived point-of-care testing in real time.
• Perform in-home procedures including: Wound care and dressing changes, Laceration repair, Splinting and immobilization, Urinary catheterization, Other procedures within provider scope and competency.
• Identify clinical deterioration and coordinate escalation to emergency department or inpatient care when necessary.
• Maintain readiness and accountability for mobile medical equipment, supplies, medications, and diagnostic tools.
• Provide longitudinal management of patients with complex chronic conditions including: Congestive heart failure (CHF), Chronic obstructive pulmonary disease (COPD), Diabetes mellitus, Chronic kidney disease (CKD), Hypertension, Other medically complex conditions.
• Develop individualized care plans and adjust therapies based on clinical response and disease progression.
• Identify early signs of clinical decompensation and intervene proactively to prevent avoidable utilization.
• Coordinate care with specialists, home health agencies, caregivers, and community resources.
• Educate patients and caregivers regarding symptom monitoring, medication adherence, and disease self-management.
• Conduct post-discharge visits for patients transitioning from hospitals, emergency departments, skilled nursing facilities, and rehabilitation settings.
• Perform comprehensive medication reconciliation and identify high-risk discrepancies during care transitions.
• Evaluate patient and caregiver understanding of discharge diagnoses, instructions, and follow-up plans.
• Develop individualized recovery plans focused on reducing readmissions and improving functional outcomes.
• Coordinate care with primary care providers, specialists, hospitalists, home health agencies, and community organizations.
• Complete all required TCM documentation and billing requirements within established timelines.
• Respond to nurse-initiated telehealth consultations for patients currently receiving home health services.
• Conduct synchronous video visits as clinically appropriate.
• Provide remote assessment, triage, and treatment recommendations to support field clinicians and patients.
• Determine when escalation to an in-person evaluation or higher level of care is necessary.
• Collaborate closely with physicians, specialists, home health clinicians, social workers, pharmacists, and care coordinators.
• Communicate assessment findings, treatment plans, and clinical changes promptly and effectively.
• Serve as a trusted clinical resource for patients, caregivers, and interdisciplinary team members.
• Support continuity of care across all settings within the patient's healthcare journey.
• Manage the clinical inbox within the electronic health record, including messages, laboratory results, refill requests, and care coordination tasks.
• Complete all documentation accurately and within 24 hours of each patient encounter.
• Maintain compliance with all applicable federal, state, and payer regulations including HIPAA and billing requirements.
• Adhere to CHP policies regarding mobile safety, vehicle operation, equipment handling, and in-home visit protocols.
• Participate in monthly clinical education sessions and ongoing quality improvement initiatives.
• Maintain active credentialing, licensure, and payer enrollment requirements.

Benefits

• Become a founding clinical provider within an innovative mobile acute care program.
• Help shape clinical workflows, protocols, operational processes, and team culture from the ground up.
• Practice with meaningful autonomy while remaining supported by a collaborative interdisciplinary team.
• Deliver care at the full scope of your training and licensure across acute care, transitional care, chronic disease management, and telehealth.
• Grow alongside a rapidly expanding organization with future leadership opportunities.
• Make a measurable impact by reducing preventable hospitalizations and improving outcomes for medically complex patients throughout the Houston community.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior