Nurse Practitioner - In Home Care

CenterWell • Corpus Christi, TX

1d • Onsite

About The Position

The Integrated Home Care Program is a dynamic and innovative initiative dedicated to transforming healthcare delivery for high-risk patients in the comfort of their own homes. The program strives to significantly reduce avoidable hospitalizations and readmissions by providing comprehensive, patient-centered care to individuals with medical complexity and functional limitations. A multidisciplinary team delivers proactive, coordinated care directly where patients need it most. The position is located in the Corpus Christi area and reports to the National Medical Director for In Home Care. As an Advanced Practice Provider (APP) within this program, the role is pivotal in enhancing the well-being of frail, medically complex, and often homebound patients. Responsibilities include conducting comprehensive in-home assessments, developing individualized treatment plans in close collaboration with the dedicated care team, and leveraging both in-person and telemedicine capabilities to deliver exceptional care. This expertise will directly contribute to enhancing patient outcomes, reducing acute care utilization, and fostering a higher quality of life for a vulnerable patient population.

Requirements

• Nurse Practitioner or Physician Assistant with 5 + years of experience in Acute care, Geriatrics, Home Health, or a related field.
• Masters Degree in Nursing
• Texas License Nurse Practitioner
• Proficiency in using Electronic Medical Record (EMR) systems for accurate and efficient documentation.

Responsibilities

• Conduct comprehensive in-home evaluations and examinations: Perform thorough assessments of enrolled patients, focusing on their medical, functional, and psychosocial needs.
• Develop and implement personalized treatment plans: Collaborate and co-manage with primary care physicians and other members of the interdisciplinary team to create and execute effective treatment strategies tailored to each patient's unique circumstances. Co-management with the patient's PCP.
• Educate and empower patients and families: Provide clear, concise education about their conditions, treatment options, medications, and the benefits of the Integrated Home Care Program, empowering them to actively participate in their care.
• Manage acute clinical issues in the home: Diagnose and treat urgent conditions, such as pneumonia, CHF/COPD exacerbations, UTIs, etc.
• Safely and effectively administer and monitor medication administration in the home setting, adhering to established protocols and ensuring patient safety.
• Maintain accurate and timely documentation: Thoroughly document all home visits, assessments, interventions, and communications within our Electronic Medical Record (EMR) system (Athena, Q4 2025).
• Participate actively in medical team meetings: Contribute to collaborative discussions, share insights, and participate in care planning during regularly scheduled team meetings on a rotating basis.
• Patient engagement: Based on coverage area you will carry a caseload of ~45 patients in a given month, ~200 unique patients per year, completing 6-8 visits per day, establishing a weekly or every-other-week cadence of visits with patients in the caseload
• Share after-hours call responsibilities: Provide timely and effective telemedicine consultations to patients and families as part of a rotating on-call schedule.

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• bonus incentive plan

What This Job Offers

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