Community Health Nurse Practitioner (Part Time) - New York

Vanna Health, Inc•New York, NY

5d•$100 - $130

About The Position

Vanna Health is seeking an experienced, recovery-focused Family Nurse Practitioner passionate about community care, health education, and whole-person wellbeing. The role serves individuals with mental illness and chronic physical health conditions in the New York City area, helping them access community-based care and improve health outcomes and quality of care. The FNP conducts timely follow-up visits within one week of emergency department or inpatient discharge, in person in the community or through telehealth, with the goal of reducing 30-day readmissions and ED re-presentations. The role supports medication adherence through education, medication reconciliation, and bridge prescriptions as needed; addresses barriers to care; and initiates or adjusts medications for members who have difficulty engaging with community providers. Additional work includes same-day urgent visits, chronic disease management for high utilizers with complex conditions, preventive care, and complex case reviews. The FNP works closely with Vanna Health’s interdisciplinary team to coordinate care, address medical and behavioral health needs, and support engagement with outpatient services.

Requirements

Active, unencumbered New York State Nurse Practitioner license in good standing with prescriptive authority.
Board certification as a Family Nurse Practitioner (FNP-C).
Ability to obtain credentialing with Optum.
Experience working with complex patients, including people with mental illness, substance use disorders, and multiple medical comorbidities in an outpatient setting.
Demonstrated experience working in interdisciplinary care teams.
Strong care coordination, communication, and organizational skills.
Ability to work independently in field-based and telehealth settings.
Willingness to learn Google, Slack, and Vanna EHR tools.
Basic computer and phone skills.
Valid driver’s license.
Belief that individuals with mental illness can recover and achieve life goals when given opportunity, support, and community.

Nice To Haves

Multi-state licensure.
Credentialing with New York State Medicaid.
Experience in transitional care, care management, or population health.
Familiarity with Medicaid populations and value-based care models.
Experience conducting home visits or providing community-based care.
Background in collaborative care.

Responsibilities

Deliver direct clinical care in person in the community, including in members’ homes, or via telehealth.
Conduct post-discharge follow-up visits within seven days for eligible members.
Perform comprehensive clinical assessments, including assessment of medical and behavioral health needs.
Conduct annual wellness visits for eligible members.
Prescribe and administer long-acting antipsychotic medications and monitor vital signs.
Conduct specified point-of-care screening and laboratory testing.
Develop and implement care plans in collaboration with an interdisciplinary team.
Coordinate care with internal team members, including RNs, physicians, coaches, community health workers, and peer specialists.
Liaise with external outpatient providers and payer care managers to ensure continuity of care and appropriate follow-up.
Identify and address barriers to care, including social determinants of health.
Support efforts to reduce 30-day ED revisits and hospital readmissions.
Ensure members are up to date on preventive care and screenings, including breast cancer screening, annual eye exams for members with diabetes, diabetes screening for members taking antipsychotic medication, and colorectal cancer screening.
Document encounters and care coordination activities in a timely and compliant manner.
Participate in team meetings, case reviews, and quality improvement initiatives.