Nurse Practitioner - Sphere Senior

About the role

Sphere Senior is an AI-native, home-based primary care program for older adults with serious, complex medical needs. The Nurse Practitioner will manage chronic conditions, navigate serious illness conversations, and build long-term patient relationships.

Responsibilities

• Conduct comprehensive in-home assessments, physical exams, acute visits, and longitudinal follow-ups for a complex geriatric patient panel
• Diagnose and manage multi-morbidity with clinical precision: heart failure, COPD, diabetes, dementia, CKD, frailty syndromes, polypharmacy, and fall risk
• Develop individualized, patient-centered care plans in collaboration with patients, caregivers, and the interdisciplinary care team and actively monitor and adjust them over time
• Prescribe medications and therapies in accordance with state scope-of-practice regulations and evidence-based protocols
• Conduct advance care planning and goals-of-care conversations with sensitivity and clinical skill
• Provide serious illness and palliative care support, including symptom management and family guidance
• Own post-hospitalization and SNF discharge follow-up to prevent avoidable readmissions, bridge visits, medication reconciliation, care plan updates
• Collaborate with care coordinators on real-time ED diversion and transition-of-care workflows
• Identify and escalate high-risk patients proactively using SphereOS risk stratification tools before crises occur
• Participate in risk stratification reviews, interdisciplinary care team huddles, and care committee meetings
• Collaborate with care coordinators, social workers, behavioral health staff, and the Medical Director on complex cases
• Contribute to quality improvement initiatives, readmission reduction, HEDIS/Stars gap closure, advance care planning rates
• Document all clinical encounters accurately and promptly within SphereOS/EHR — complete, billable, compliant
• Respond to urgent clinical needs during shift hours in coordination with on-call protocols
• Participate in structured after-hours on-call rotation (low-burden, shared with Medical Director and APP team)

Requirements

• Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)
• Active, unrestricted NP license in the state(s) of practice
• National certification: ANCC (AGPCNP-BC preferred, FNP-BC accepted) or AANP (FNP-C)
• Active DEA registration (or ability to obtain prior to start)
• BLS certification; ACLS preferred
• 2+ years of NP experience in geriatrics, primary care, home-based care, SNF/LTC, or complex care management
• Demonstrated comfort with telehealth, digital health tools, and AI-assisted clinical workflows
• Strong interpersonal skills — clear communicator across varying health literacy levels
• Valid driver's license and reliable transportation (in-home travel required)

Qualifications

• Experience in home-based primary care (HBPC), PACE, or value-based care programs
• Palliative care training or certification (ACHPN or equivalent)
• Familiarity with risk stratification tools: HCC coding, LACE index, CMS-HCC models
• Experience with ACO, MSSP, or Medicare Advantage quality programs
• Bilingual — Spanish, Mandarin, Cantonese, Vietnamese, or other languages spoken by patient communities
• Comfort working independently in field-based settings with minimal on-site supervision

Benefits

Sphere Senior offers a flexible schedule designed for clinician sustainability. Options include:

• Option A (standard): 4 × 10-hour shifts/week
• Option B: 3 × 12-hour shifts/week + 1 administrative/remote half-day
• No mandatory overnight shifts
• Structured, shared on-call rotation — low-burden and predictable
• Weekend expectations discussed transparently during the hiring process

Pay

Competitive salary commensurate with experience and qualifications.

Schedule

Flexible scheduling options to accommodate both clinical needs and personal life. No mandatory overnight shifts.

Why Sphere Senior?

Unlike traditional NP roles, Sphere Senior offers a real patient panel, real clinical ownership, and real relationships backed by a Medical Director in the field, a technology platform that makes your job easier, and a team invested in your success.