Nurse Practitioner
3 days ago
At ComplexCare Solutions, we are dedicated to delivering high-quality, in-home and virtual assessments to individuals in need. Our team of skilled professionals is passionate about making a difference in the lives of our members, and we are seeking a Nurse Practitioner to join our team.
We pride ourselves on our member engagement, which focuses on evaluating current health status, identifying gaps in care, and developing personalized care plans to improve clinical outcomes. Our visits provide Providers with the opportunity to spend quality time with members, capturing a comprehensive picture of their needs and developing strategies to keep them safe and healthy in their homes.
Responsibilities- Stay up-to-date on CMS Regulations and NCQA HEDIS Guidelines
- Apply evidence-based clinical practice standards, including those from the American Diabetes Association, American College of Cardiology, and American Heart Association
- Utilize ICD-9, ICD-10, and CPT-4 coding practices to ensure accurate documentation
- Conduct comprehensive reviews of assigned member populations, completing all required documentation in a timely manner
- Ensure accurate and thorough documentation of member medical conditions, adhering to CMS/DHHS, Inovalon policy, and client requirements
- Support the physician-patient relationship, ensuring timely and adequate communication and documentation of assessment findings
- Make recommendations to members to improve their knowledge of chronic conditions, including information on recommended testing
- Address and close identified gaps in care, including disease-specific and preventive services
- Recognize emergent or urgent situations, taking appropriate action as specified in Inovalon policies and professional standards
- Perform, document, and communicate results of Point of Care (POC) Testing
- Maintain compliance with Inovalon policies, procedures, and mission statement
- Adhere to confidentiality and HIPAA requirements at all times
- Active, unencumbered license to practice nursing
- Nurse Practitioner Certification from the ANCC or AANP in Family, Adult, Gerontology, or Emergency Medicine
- Current CPR certification
- Compliance with recommended Healthcare Personnel Requirements for vaccinations and preventive testing
- Ability to effectively communicate with elderly and chronically ill patients and families
- Understanding of Medicare, Medicaid, and Health Plan benefit structures
- Ability to multitask and provide excellent customer service
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