Nurse Practitioner

4 weeks ago

Lawrenceville, Georgia, United States ComplexCare Solutions Full time
Job Title: Nurse Practitioner

Job Summary:
ComplexCare Solutions (CCS) is seeking a skilled Nurse Practitioner to join our team. As a Nurse Practitioner with CCS, you will have the opportunity to work with a diverse population of patients, providing in-home and virtual assessments to help them achieve better health outcomes.

Responsibilities:
• Conduct comprehensive, accurate, and thorough reviews of assigned member populations, including timely completion and submission of all required encounter documentation (paper or electronic).
• Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Inovalon 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 required if necessary, and need for follow-up and timelines for follow-up to primary care provider (PCP) and health plan as required.
• Make general recommendations to members intended to improve members' knowledge of their chronic condition(s), such as information concerning 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 Inovalon policies, and as determined by reasonable professional judgment and ethical professional practice standards.
• Perform, document, and communicate results of Point of Care (POC) Testing.
• Maintain compliance with Inovalon's policies, procedures, and mission statement.
• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position.
• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company.
• Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.

Qualifications:
• Active, un-encumbered license to practice nursing.
• Nurse Practitioner Certification from either the ANCC or AANP 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, Pertussis, Tetanus, and diphtheria and acellular pertussis (Tdap), Varicella, and Tuberculosis.
• 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.

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