Nurse Practitioner - Home Visits - Per Diem
Company: ComplexCare Solutions
Location: Mobile
Posted on: November 11, 2024
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Job Description:
Overview
ComplexCare Solutions (CCS) specializes in helping those in need by
delivering high value in-home and virtual assessments for health
plans nationwide. We pride ourselves on our member engagement aimed
towards evaluating current health status, gaps in care, potential
health risks and care management opportunities with a focus on
driving better clinical outcomes. Our visits give Providers the
opportunity to spend a full hour with these members which allows
them to capture a comprehensive picture of that individual's
personal needs and what is required to keep them in the home and
out of the hospital.
CCS is calling on Nurse Practitioners that are passionate about
helping their local communities. We care dearly about those we
serve and we need your help to make a difference in the lives of
our members.
Responsibilities
Knowledge of CMS Regulations and NCQA HEDIS Guidelines;
Knowledge of Evidence-based Clinical Practice Standards: American
Diabetes Association (ADA), American College of Cardiology (ACC),
American Heart Association (AHA)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.
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;
We reserve the right to change this job description from time to
time as business needs dictate and will provide notice of such.
Other duties as assigned
Qualifications
NPHJ21
Studies have shown that women and people of color are less likely
to apply for jobs unless they believe they meet every one of the
qualifications listed in a job description. If you don't meet every
qualification listed but are excited about our mission and the work
described, we encourage you to apply regardless. ComplexCare
Solutions is most interested in finding the best candidate for the
job and you may be just the right person for this or other
roles.
By embracing diversity, equity and inclusion we enhance our work
environment and drive business success. ComplexCare Solutions
strives to reflect the diversity of the communities where we
operate and of our clients and everyone whom we serve. We endeavor
to create a culture of inclusion in which our associates feel
empowered to bring their full, authentic selves to work and pursue
their professional goals in an equitable setting. We understand
that by fostering this type of culture, and welcoming different
perspectives, we generate innovation and growth.
ComplexCare Solutions is proud to be an equal opportunity workplace
and is an affirmative action employer. We are committed to equal
employment opportunity regardless of race, color, ancestry,
religion, sex, national origin, sexual orientation, age,
citizenship, marital status, disability, gender identity or Veteran
status. We also consider qualified applicants regardless of
criminal histories, consistent with legal requirement.
The Company maintains a drug free work environment for all of its
associates, which includes employees, contractors and vendors. It
is unlawful for associates to manufacture, sell, distribute,
dispense, possess or use any controlled substance or marijuana in
the workplace and doing so will result in disciplinary action, up
to and including termination of employment or the contracted
relationship.
To review the legal requirements, including all labor law posters,
please visit this link
Keywords: ComplexCare Solutions, Gulf Port , Nurse Practitioner - Home Visits - Per Diem, Other , Mobile, Mississippi
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