Geriatric Nurse Practitioner

Harbor Health Services, Inc.•Boston, MA

4d•$115,518 - $173,328•Onsite

About The Position

Harbor Health Services is a mission-based organization providing medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. Its Elder Service Plan operates two Programs for All-Inclusive Care for the Elderly (PACE) in Mattapan and Brockton, serving more than 600 frail elders. The Geriatric Nurse Practitioner provides primary care services to Elder Service Plan-PACE participants in collaboration with the PACE physician. The role manages acute and chronic illnesses, provides routine preventive and health-management services, makes appropriate referrals for medical and non-medical conditions, and collaborates with the PACE interdisciplinary team. The position is based at the Elder Service Plan at 1135 Morton Street in Mattapan, Massachusetts. The PACE interdisciplinary team manages care for frail elders in small patient panels of 75. Participants attend the center for adult day health activities and receive on-site clinical care, including primary care, behavioral health, and rehabilitation. Nurse practitioners follow participants across care settings, including sub-acute, long-term, and home care; regular home visits are encouraged, and time is allotted for this work.

Requirements

Master of Science in Nursing (MSN) in Geriatric Nursing or a related specialty field.
Current Massachusetts RN/NP license and current Nurse Practitioner certification.
Current MCSR, DEA, and Basic Life Support for Health Care Provider certification.
At least one year of experience working with a frail or elderly population; two or more years is preferred.
Strong clinical, leadership, interpersonal, and organizational skills.
Experience working with an Interdisciplinary Team (IDT).
Experience in developing and implementing geriatric programs.
Ability to travel in a timely manner to ESP sites, participants’ homes, and affiliated sites as needed.

Nice To Haves

Two or more years of experience working with a frail or elderly population.
Familiarity with medications.
Knowledge of community resources.

Responsibilities

Provide primary care to PACE participants in collaboration with the PACE physician at the Mattapan ESP site, affiliated sites, and participants’ homes as needed.
Conduct health assessments and evaluate patient needs at the PACE center, assisted living facilities, skilled nursing facilities, or participants’ homes.
Participate in developing a comprehensive plan of care for each participant.
Participate in an on-call system with other providers to ensure 24-hour access to care for participants.
Participate in provider staff, departmental, and general staff meetings; trainings; interdisciplinary team meetings; and quality improvement activities.
Make appropriate, cost-efficient referral decisions, primarily to contracted specialists, and provide guidance and monitoring of systems needed to operate a capitated care program.
Update the Electronic Medical Record using appropriate coding and document care accurately and promptly, including progress notes, lab follow-ups, and communications with participants; maintain current problem lists, medication flow sheets, immunization records, and other appropriate information.