Physician Extender APP, Nephrology

ChenMed•Glenwood, MN

2d•$111,140 - $158,771•Remote

About The Position

The Nephrology Extender provides coordination of quality care for CKD and ESRD patients between primary care physicians, community nephrologists and dialysis clinics. Reporting to the National Director of Nephrology, the incumbent will be responsible for identifying opportunities to minimize fragmentation of health care for ESRD and CKD patients. They will continually seek to improve patient and quality outcomes, monitoring program performance across multiple medical centers. They will be responsible for patient education and will help develop strategies for quality improvement and management.

Requirements

Licensed Physician Assistant or Nurse Practitioner
5+ years of nephrology experience
Nephrology CAQ or Certified Nephrology Nurse (CNN) preferred
Experience with care coordination and coaching
Excellent verbal and written communication skills
Intermediate computer skills with Microsoft Office Suite products, including Excel and Word
Medicare and/or Medicare Advantage experience a plus
Prior experience in a value based care (e.g. ESCO) , risk-model based healthcare a plus

Responsibilities

Works directly with the National Director of Nephrology to analyze care gaps sharing recommendations with PCPs and dialysis clinics to decrease crash into dialysis.
Responsible for care coordination between ChenMed Nephrology team, PCPs, Dialysis units and vascular or inpatient care facilities.
Ability to review patient charts, provide assessments and recommendations for care plan.
Enhances home dialysis utilization for patients with emphasis on increasing de-novo start of home dialysis.
Works with transitional care team on decreasing ESRD hospitalizations and length of stay
Provides virtual education to patients on CKD and options for dialysis.
Develops trusting relationships with all internal and external stakeholders to determine areas of opportunity supplemented with remediation strategies.
Supports and completes ad-hoc initiatives including, but not limited to research and care advancement proposals.
Ability to travel up to 75%
Other duties as assigned.
Analyze gaps in care and make recommendations to Dr Kheda/PCP
Nephrology and transplant referral management
Chart reviews and provide assessment if candidate for home dialysis'
Assist in development of CKD patient education material
Provide virtual education to patients on CKD and dialysis options
Care coordinate with community nephrologist to avoid ‘Crashing into Dialysis’
Increase de-novo start of home dialysis
Decrease Crash into Dialysis
Analyze gaps in care and make recommendations to Dr Kheda/PCP/dialysis clinics
Do virtual assessment if candidate to transition to home dialysis
Care coordination with TCM team on decreasing ESRD hospitalizations and LOS
Care coordinate between ChenMed, Dialysis unit, vascular and inpatient care
Increase proportion of patients on home dialysis
Decrease hospitalization rate and LOS