APP - Nurse Practitioner or Physician Assistant

ConcertoCare•Brooklyn, NY

45d•$135,000 - $160,000

About The Position

The ConcertoCare Advanced Practice Provider (Nurse Practitioner and Physician Assistant) delivers in-home clinical services to patients with the support of an integrated multidisciplinary care team. We offer a wraparound care model including a broad scope of clinical services and care coordination support that is complimentary to but does not replace primary care services for our patients. Our Advanced Practice Providers build meaningful relationships with patients and their caregivers, delivering proactive and timely care aligned with what matters most to our patients to improve their quality of life and to avoid unnecessary ER visits and hospitalizations. In this role, you will deliver in-home care through a blend of in-person visits and virtual visits with the support of nurses, community health workers, medical assistants, nurse case managers, social workers, and clinical pharmacists. This position also affords professional development via dedicated clinical education programming and real-time support from our on-staff world-class experts in geriatric medicine, palliative care, geriatric psychiatry, clinical pharmacy, care management, and social determinants of health and health equity.

Requirements

Nurse Practitioner with graduation from an accredited health professions school and successful completion of an ANCC or AANP certification; or board-certified Physician Assistant. Nurse Practitioners who only possess PMHNP or NNP certifications, are not eligible for this position.
Active licensure in New York.
Active DEA licensure and state-specific controlled substance registration, as applicable.
Certification in basic life support (BLS) required.
Clinical experience caring for aging adults and adults with complex care needs required.
Clinical experience providing virtual care via telehealth
Average to advanced computer and software skills required.
Ability and means to travel as needed in a timely manner to locations that may have limited access to public transportation; proof of liability and property damage insurance on vehicle used is required.
DRIVER REQUIREMENTS IF DRIVING YOUR OWN VEHICLE: Licensed for a minimum of 5 years. No vehicle-related suspensions, DUI, reckless driving, leaving the scene of an accident, vehicular manslaughter, felony convictions, or 3 or more moving violations within the last 5 years. No more than 2 moving violations or 1 at-fault accident in the last 3 years.

Nice To Haves

Bilingual speakers preferred.
Advanced training in geriatrics and/or palliative medicine preferred.
Clinical experience caring for patients in the home setting including private homes and/or congregate living facilities preferred.
Previous experience with managed care and/or value-based healthcare delivery preferred.

Responsibilities

Provision of compassionate, individualized, and holistic patient care including comprehensive care, urgent care, and chronic condition management focused on gaps in care, patient risk stratification, and integration with multidisciplinary team services.
Collaboration with the multidisciplinary team to cooperatively deliver transitions of care support, social determinants of health interventions, behavioral health evaluation and management, and complex medication management as clinically appropriate.
Delivery of exceptional clinical care both in-person and virtually, with in-person settings including private homes, congregate living facilities, and/or other home settings.
Integration of clinical practices, data dashboards, and operational processes that support the achievement of company performance goals into daily clinical workflows.
Promotion of and participation in patient engagement and experience initiatives.
Maintenance of comprehensive medical records including timely and accurate completion of clinical documentation and coding for clinical encounters, up-to-date medication reconciliation, and accurate recording of patient care-related activities and communications.
Active participation in care team huddles, operational huddles, organizational meetings, educational training, and clinical partnership meetings as requested.
Collaboration with external providers and clinical partners including outreach to initiate relationship-building conversations and ongoing communication to coordinate care and to sustain key partnerships with PCPs and other clinical partners.
Enjoy a healthy work-life balance with limited after-hours responsibilities. Rotating on-call coverage is strictly telephonic and only required in cases when a relevant issue is escalated by a Triage RN.
Other market-specific duties as assigned.