APP - PACE Nurse Practitioner -

UofL Health•Louisville, KY

About The Position

The Advanced Practice Registered Nurse (APRN) provides assessment, management and outcome evaluation for patients in inpatient and outpatient settings. The APRN serves as a resource to educate patients, families, professional nurses, and staff; functions as a liaison between patient, family and UofL Physicians staff; and participates in clinical research. The APRN should demonstrate an advanced level of medical and nursing knowledge, clinical and technical competency, sound clinical judgment, professionalism as it relates to interpersonal and general communication skills, timely and compliant documentation, and takes responsibility for ongoing professional development and competency validation. PRIMARY RELATIONSHIPS: Medical Director, Executive Director, Primary Care Physicians, Center Managers, co-workers, participants, family members and public. OBJECTIVE: Under the supervision of the Executive Director, with Medical Director oversight, provides primary care to participants. Performs physical assessments of new PACE Enrollees, semi-annual reassessments of participants and develops and implements appropriate plans of care to Senior CommUnity Care program participants. Evaluates participant physical complaints and provides appropriate treatment. Provides participants and caregiver teaching and education. Functions as a member of the Interdisciplinary Team (IDT). Demonstrates the knowledge and skills necessary to assess, plan, care for, and provide services to frail elder participants according to assigned responsibilities and Senior Community Care standards.

Requirements

Must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.
Must have a valid driver’s license, proof of insurance and have means of transportation.
Education: Graduate of a school of professional nursing required. Licensed as Registered Nurse (R.N.) in the state of employment. Certified as a nurse practitioner by a national certifying organization recognized by the State Board of Nursing. Prescriptive authority required within one year of hire.
Experience: A minimum of one year of experience in working with the frail and elderly population required.
Skills and Knowledge: Thorough knowledge of current concepts, theories and practices related to home and community based care for the elderly and disabled adults. Working knowledge of the PACE regulations desired. Thorough knowledge of physical, mental and social needs of frail older adults. Effective oral and written communication skills.
Ability to lead and work within the interdisciplinary setting. Strong organizational skills.
Able to manage changing priorities per needs of the PACE program and the agency. Ability to utilize computers and other electronic devices for tasks such as timekeeping, in-servicing and documentation.

Nice To Haves

Certified as a Geriatric Nurse Practitioner (G.N.P.) preferred.
Two (2) years of experience as a nurse practitioner in a geriatric setting preferred.

Responsibilities

Performs in person comprehensive history and physical assessments of new Senior CommUnity Care PACE participants.
Coordinates with the Interdisciplinary Team to develop a comprehensive plan of care for each participant.
Conducts an in-person re-assessment semi-annually and as needed.
Works with team members to meet emergent and acute medical and non-medical needs of participants.
Participates in discharge planning for participants in acute, skilled and long-term care settings.
Manages, evaluates and treats participants with chronic diseases, maximizing interventions in the PACE clinic or the participant’s home prior to initiating a higher level of care.
Evaluates and treats participants with acute illnesses, maximizing interventions in the PACE clinic or the participant’s home prior to initiating a higher level of care.
Following consultation with the Primary Care Physician refers participants to medical specialists as indicated.
Responsible for the oversight of the care of PACE participants who reside in a Skilled Nursing Facility.
Provide medical care and treatment of PACE participants who reside in a Skilled Nursing Facility.
Participates in the on-call rotation.
Maintains participants’ medical record and fulfills Senior CommUnity Care charting and reporting requirements.
Functions as a member of the Interdisciplinary Team. Maintains regular attendance at, and participants in Interdisciplinary Team meetings; communicates participant changes, collaborates on plan of care decisions and coordination for twenty-four (24) hour care delivery.
Provides relevant participant and caregiver education. Educates and trains participant and caregivers in appropriate care and interventions.
Provides staff in-service on a variety of relevant topics.
Completion and documentation of appropriate diagnostic coding. 3 2025
Assists with the development of, standards of care; performs on-going monitoring and evaluation of patient care practice and service delivery; provides guidance and training to staff regarding medical and quality assurance issues.
Acts within the scope of his or her authority to practice.
Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants and families.
Follows all Senior CommUnity Care policies and procedures and Occupational Safety and Health Agency (OSHA) safety guidelines.
Participates in continuing education classes and any required staff and training meetings. Maintains professional licensure and certifications.
Provides information about Senior CommUnity Care Program to interested individuals and groups in adherence to PACE regulations.
Practices Universal Precautions and follows all appropriate infection control procedures.
Participates in and supports Quality Improvement Initiatives.
Performs other duties as required or requested