Nurse Practitioner (Per Diem)

About the role

ComplexCare Solutions (CCS) specializes in delivering high-value home and virtual assessments for health plans nationwide. We focus on evaluating current health status, identifying gaps in care, potential health risks, and care management opportunities to drive better clinical outcomes. Providers have the opportunity to spend a full hour with members, capturing a comprehensive picture of their personal needs to keep them in the home and out of the hospital.

Responsibilities

• Complete comprehensive, accurate, and thorough review of assigned member population, including timely completion and submission of all required encounter documentation (paper or electronic).
• Ensure all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, company policy, and client requirements.
• Support the physician/patient relationship and ensure timely and adequate communication, documentation of assessment findings, recommendations, need for additional services, emergency services if necessary, and follow-up timelines to primary care provider (PCP) and health plan as required.
• Make general recommendations to members to improve their knowledge of chronic conditions, such as recommended testing.
• Address and close identified gaps in care (disease-specific or preventive).
• Recognize emergent or urgent situations requiring escalation and take appropriate action as specified in company policies and professional standards.
• Perform, document, and communicate results of Point of Care (POC) Testing.
• Maintain compliance with company policies, procedures, and mission statement.
• Adhere to all confidentiality and HIPAA requirements.
• Fulfill responsibilities and/or duties to achieve operational and financial success of the company.
• Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.
• Be available for a minimum of 25 slots of availability per month (approximately 37 hours).

Requirements

• Active un-encumbered license to practice nursing.
• ANCC or AANP board certification as a Nurse Practitioner or Clinical Nurse Specialist in Family, Adult, Gerontology, or Emergency Medicine.
• Maintains current CPR certification.
• Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing:
  • Hepatitis B
  • Influenza
  • MMR: Measles, Mumps and Rubella
  • Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap)
  • Varicella
  • Tuberculosis

Qualifications

• Knowledge of CMS Regulations and NCQA HEDIS Guidelines.
• Knowledge of Evidence-based Clinical Practice Standards:
  • American Diabetes Association (ADA)
  • American College of Cardiology (ACC)
  • American Heart Association (AHA)
• Familiarity with ICD-10 and CPT-4 coding practices.
• Home Health experience a plus.
• Must be able to effectively communicate with elderly and chronically ill patients and families.
• Understanding of Medicare, Medicaid, and Health Plan benefit structures beneficial.
• Ability to multitask.
• Excellent customer service skills.
• Bi-lingual or multi-lingual a plus.
• Ability to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making sound clinical decisions without direct on-site supervision.
• Proficient with computer platforms, electronic health records (EHRs), secure messaging systems, and cloud-based documentation tools.

Pay

• Pay Range: $2,400.00 - $10,000.00 per month (Potential income). Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income.
• In-home visit rate: $120 - $140 depending on state of residence.
• Telehealth rate: $85 per completed assessment (if available).

Benefits

• Eligible to participate in a company 401K plan with automatic enrollment at a 3% contribution rate (option to opt out).