Primary Care Nurse Practitioner

4 weeks ago

Cleveland, United States AbsoluteCARE Inc Full time

Join Our Dynamic Team as a Community-Based Clinician

Are you passionate about providing exceptional primary and urgent care? We are seeking a dedicated Primary Care Nurse Practitioner to deliver crucial medical and care-coordination services, particularly focusing on patients transitioning from hospital to home. This role is a unique opportunity to make a real difference in the lives of vulnerable patients, working closely with their existing care providers to enhance their health outcomes.

Duties and Responsibilities:

  • Provide community-based medical care and support for recent hospital discharges.
  • Manage a small panel of homebound members requiring primary care and effective solutions.
  • Conduct on-site and home visit clinical care, addressing a range of conditions including:
  • Acute onset of new illnesses.
  • Exacerbations of chronic conditions.
  • Shortness of breath without chest pain and other acute symptoms.
  • CHF, asthma, or COPD exacerbations.
  • Infections, hyperglycemia, elevated blood pressure, depression, and anxiety.
  • Health issues likely to lead members to seek ER care.

Ensure seamless coordination of care by:

  • Completing chart documents accurately and timely.
  • Collaborating with the Treatment and Triage Nurse for sick calls and provider management.
  • Partnering with the Core Clinical Team to define and meet visit goals.
  • Communicating critical follow-up information post-visit.
  • Working with members of the Integrated Care Team for holistic problem-solving.
  • Referring to specialty programs in cases of crisis or instability, addressing needs like housing and food insecurity.
  • Implementing transitional care protocols to facilitate warm handoffs.
  • Helping patients navigate barriers to health and life goals, connecting them to community resources.
  • Adjusting care plans according to evidence-based chronic disease management guidelines.
  • Educating and coaching patients on medication adherence and self-management.
  • Monitoring at-risk members to prevent loss to care and implementing interventions when necessary.

If you're eager to make a meaningful impact in a supportive and collaborative environment, we invite you to apply and join us in transforming the care experience for our members

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