Palliative Care Nurse Practitioner I

DaVita•Richmond, VA

1d•Remote

About The Position

The Palliative Care Nurse Practitioner I provides specialized, person- and family-centered care for adults living with advanced chronic kidney disease (CKD), end-stage kidney disease (ESKD), and complex comorbid conditions. The primary mission is to connect patients with external palliative and hospice care aligned with their values and goals. The NP identifies eligible patients, leads goals-of-care discussions, facilitates orders and referrals within scope, and promotes equitable access to concurrent hospice and dialysis care. As a clinical leader, the NP guides an assigned interdisciplinary team (IDT) of registered nurses and licensed clinical social workers, supporting collaborative care planning, case reviews, and transitions across care settings. The role also partners across Integrated Kidney Care (IKC) to advance clinical quality and program outcomes. DaVita IKC provides holistic chronic care management across the kidney care continuum, integrating nurse practitioners, registered nurses, licensed clinical social workers, and care coordinators to support patients' clinical and psychosocial needs outside the dialysis clinic.

Requirements

Master’s or doctoral degree from an accredited Nurse Practitioner program.
Current, unrestricted RN and APRN/NP license in the state(s) of practice.
Current national board certification in an adult-focused population, such as AGPCNP, AGACNP, or FNP.
Current BLS/CPR certification.
Eligibility to obtain DEA registration and state controlled-substance authority, as applicable.
At least 5 years of Nurse Practitioner experience managing adults with serious or complex illness.
Experience in palliative care, hospice, nephrology, geriatrics, or complex care management.
Demonstrated expertise in serious illness communication, advance care planning, pain and symptom management (including controlled substances and renal dosing), and conservative kidney management.
Experience guiding interdisciplinary clinical teams, including registered nurses and social workers, and navigating multi-stakeholder care coordination.
Ability to become credentialed with DaVita Kidney Care, Medicare, and commercial payers.
Proficiency with electronic health record systems, including Cerner and EPIC, and ability to demonstrate functional proficiency within 90 days.
Intermediate proficiency in Microsoft Office Suite, including Word, Excel, and Outlook.
Strong commitment to patient confidentiality, compliance, and ethical clinical practice.

Nice To Haves

Advanced Certified Hospice and Palliative Nurse (ACHPN®) certification.

Responsibilities

Coordinate external palliative care and hospice transitions from initial recommendation through start of care; confirm eligibility, assess patient and family goals, address clinical questions, complete referrals within scope or collaborate to secure required orders, and ensure complete records and warm handoffs.
Partner with hospice agencies, nephrology practices, dialysis clinics, and payers to facilitate concurrent hospice and dialysis care; track referral status and resolve transition barriers.
Evaluate and manage complex symptoms associated with advanced kidney disease and serious comorbid illnesses using evidence-based pharmacologic and non-pharmacologic interventions, including prescribing or deprescribing within scope, renal drug dosing, and diagnostic studies.
Coordinate symptom management plans with nephrology, hospice, external palliative care, and primary care teams across transitions.
Conduct comprehensive palliative assessments of physical symptoms, functional and cognitive status, psychosocial and spiritual needs, caregiver support, health literacy, treatment burden, prognosis, and quality-of-life priorities.
Review medical records, diagnostic and laboratory trends, medication regimens, and utilization history to develop individualized care plans with patients, families, and the IKC interdisciplinary team.
Lead culturally responsive, values-based discussions about illness understanding, prognosis, and treatment preferences; facilitate shared decisions about dialysis, conservative kidney management, resuscitation, and life-sustaining treatments.
Facilitate advance directives, healthcare proxy documentation, and portable medical orders such as POLST/MOLST.
Provide clinical guidance to an assigned interdisciplinary team, leading case reviews, care planning, clinical prioritization, and closed-loop communication.
Collaborate with care coordinators, clinical operations, quality improvement, and leadership stakeholders to optimize workflows and integrate palliative care across the IKC model.
Document assessments, shared decision-making, referrals, provider collaboration, barriers, and transition milestones promptly and accurately.
Support clinical quality metrics, including time to start of care, referral completion rates, and transition outcomes.
Perform other duties as assigned.