Nurse Practitioner Position
6 hours ago
We are seeking a skilled Nurse Practitioner to join our team at ComplexCare Solutions. As a Nurse Practitioner, you will play a vital role in delivering high-quality healthcare services to our members.
Responsibilities:- Knowledge of CMS Regulations and NCQA HEDIS Guidelines;
- Familiarity with ICD-9, ICD-10 and CPT-4 coding practices;
- Complete comprehensive, accurate and thorough review of the assigned member population, 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; and
- Perform, document and communicate results of Point of Care (POC) Testing.
- Active un-encumbered license to practice nursing;
- Nurse Practitioner Certification from either the ANCC or AANP; in Family, Adult, Gerontology or Emergency Medicine.
- Board Certified through the AANP or ANCC
- 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
We offer a competitive compensation package and opportunities for professional growth and development. If you are a motivated and compassionate healthcare professional looking for a new challenge, please submit your application.
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