Advanced Practice Practitioner (NP/PA)

About the role

Reporting to the Clinical Manager, the Advanced Practice Practitioner (NP/PA) is responsible for conducting patient visits, ensuring effective collaboration, proper clinical management, documentation of visits, and high-quality patient care delivery to Grace at Home family members. This role involves direct patient care in-person and via telehealth to meet organizational goals, improve member outcomes, and provide exceptional patient care. The position is accountable for ensuring Grace at Home is positioned to innovatively deliver on its promise and should embody Care at Home’s core values: Trusted, Empathetic, Committed, Humble, Creative, and Community-Minded.

The Nurse Practitioner will have a strong knowledge base in providing care in the home, Value Based Care, HEDIS and Stars, documentation and coding, and medical practice principles. They will stay informed about advancements in healthcare practices and disseminate relevant knowledge.

Responsibilities

• Deliver comprehensive and follow-up care through in-home and virtual visits, including AWVs, Comprehensive Assessments, Follow-up visits, and TOCs (Transitions of Care) in accordance with Medicare, Medicaid, and commercial plan requirements.
• Practice value-based, home-centered care focused on quality, cost reduction, population health outcomes, and patient satisfaction.
• Provide ongoing management of acute and chronic conditions, collaborating with multidisciplinary teams to develop and implement individualized care plans.
• Participate in daily huddles and interdisciplinary team meetings to enhance patient care coordination.
• Prescribe medications, therapies, and lifestyle interventions within scope of practice.
• Communicate clearly and compassionately with Family Members, supporting prevention, chronic disease management, and health education.
• Provide on-call backup support to the nurse line in licensed states, requiring additional state licensure for cross-coverage.
• Maintain accurate documentation in the EMR and demonstrate proficiency with practice management systems.
• Ensure compliance with clinical ethics, HIPAA, and all applicable federal and state regulations.
• Participate in quality improvement initiatives, professional development, and other duties as assigned.

Requirements

• Master’s degree in nursing or related science field required.
• Active and unrestricted NP/PA license required in the state of hire.
• 2+ years of direct patient care as a Nurse Practitioner strongly preferred; community-based care experience preferred.
• Experience with Medicare/Medicaid is preferred.
• 2+ years of clinical experience treating complex chronic conditions and high-needs patients; Medicare and LTSS experience preferred.
• Excellent verbal, written, presentation, and group facilitation skills.
• Strong critical analytic, thinking, and communication skills.
• Excellent computer skills, particularly Microsoft applications including Word, Excel, PowerPoint, and Outlook.
• Willingness to explore and learn new or unfamiliar applications that may benefit the clinical team.
• Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced organization.

Working Environment

• Visits are conducted in patient homes as well as remotely via telehealth; travel to patient homes is required.
• In-office work is performed indoors in a traditional office setting with air conditioning, artificial light, and an open workspace.
• Regular communication with customers, vendors, management, and co-workers, sometimes with people who are agitated.
• Regular use of telephone and email for communication is essential.
• Sitting for extended periods is common.
• Must be able to receive ordinary information and prepare or inspect documents.
• Lifting of up to 10 lbs. occasionally may be required.
• Good manual dexterity for the use of common office equipment such as computer terminals, calculators, copiers, and FAX machines.
• Good reasoning ability to understand and utilize management reports, memos, and other documents.

Benefits

Financial Well-being

• Competitive Compensation: Competitive salaries to attract and retain the best talent.
• 401(k) with Employer Match: 401(k) plan with a generous 4% employer match.

Health and Wellness

• Comprehensive Medical Plan: Comprehensive medical option with an employer contribution.
• Dental & Vision Coverage: Employer-paid dental and vision plans via MetLife.
• Employer-Paid Insurance: Life, Short-Term Disability (STD), and Long-Term Disability (LTD) insurance provided at no cost.
• Generous Paid Time Off: Ample time off for rest and rejuvenation with generous PTO, holidays, and wellness time.

Additional Perks

• Continuing Medical Education (CME) Allowance for APPs.
• Commuter Benefits: Save on your commute with the commuter benefits program.
• Mileage Reimbursement: Reimbursement for work-related travel expenses.