Palliative Advanced Practice Provider
About The Position
Monogram Health is seeking a full-time Palliative Care Advanced Practice Provider (APP) to support its nationwide growth. This in-market provider delivers in-home care to a highly complex patient population, including end-of-life patients with CKD/ESRD, diabetes, COPD, and CHF. The APP works with the Market Physician Executive, Palliative Care Lead Physician, and an interdisciplinary team to provide palliative care and clinical guidance to patients and families, manage pain and symptoms, develop appropriate care plans, and document advance directives to support patient-centered care. The position is remote, with periodic training and meetings outside the employee’s home state. Monogram Health provides comprehensive, personalized, evidence-based care for people with multiple chronic conditions. Its multidisciplinary clinical team includes specialists in nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care, and supports patients with clinical care, medication management, education, counseling, and practical needs.
Requirements
- Active and unrestricted Nurse Practitioner or Physician Assistant license.
- Board certification appropriate to licensure: ANCC or AANP for Nurse Practitioners; NCCPA for Physician Assistants.
- Current and unrestricted DEA certificate.
- At least two years of experience working with patients in a palliative care setting; other relevant experience will be considered.
- Ability to work without direct supervision and practice autonomously.
- Reliable transportation and ability to travel within the designated region for patient needs, including in-home and clinic visits as needed; access to transportation, a valid driver’s license, and car insurance.
- Active state-specific licensure and willingness to become licensed in multiple states as company and patient needs require.
Nice To Haves
- Certification in ACHPN or CHPN.
- Demonstrated experience in clinical assessment, care plan design, and evaluating patients using evidence-based clinical criteria.
- Communication skills for sensitive conversations about prognosis and end-of-life decisions, including goals-of-care discussions and advance care planning.
- Proficiency with electronic health record (EHR) systems for documenting complex case details.
Responsibilities
- Partner with the Market Physician Executive and clinical leaders, including the Palliative Care physician, to identify eligible patients, build panels, and develop individualized, evidence-based care plans aligned with patient goals.
- Deliver compassionate, patient-centered palliative care primarily through in-home visits, with virtual visits as needed. Conduct assessments and annual wellness exams, manage symptoms, and develop treatment plans.
- Prescribe medications, order tests, and manage medication regimens in collaboration with pharmacists and the patient’s Monogram physician.
- Conduct ongoing follow-up and evaluate patient status, adjusting care plans as needed.
- Educate patients and families about disease progression, including CKD, ESKD, and related conditions; treatment options; and palliative and hospice principles.
- Guide families through complex medical decisions, prognosis discussions, and advance care planning, including documenting AD/POLST forms.
- Support hospice transitions when appropriate.
- Coordinate care with primary care providers, specialists, ancillary services, and the interdisciplinary team, including the Palliative Care Chaplain.
- Participate in integrated care team meetings and monthly clinical leadership meetings to drive program KPIs.
- Complete timely, comprehensive documentation, including chief complaint, diagnoses, history, ROS, examination, and assessment and plan.
- Close care gaps through preventive monitoring education and diagnostic scheduling.
- Meet daily-tracked quality outcome metrics.
- Educate patients and families about available benefits and programs that support healthier living.
- Train team members on palliative and hospice care, advance directives, symptom assessment, and communication.
- Support patient enrollment in educational resources.
Benefits
- Medical, dental, and vision insurance.
- Employee assistance program.
- Employer-paid and voluntary life insurance.
- Disability insurance.
- Health and flexible spending accounts.
- 401(k) with employer match.
- Financial wellness resources.
- 20 PTO days, 7 paid holidays, and 1 floating day.
- Paid parental leave.
- Work-life assistance resources.
- Physical wellness perks.
- Mental health support.
- Employee referral program.
- BenefitHub employee discounts.
- Bonus opportunities.
- Competitive compensation.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
