Company DescriptionAbout Health Prime International, LLC: HPI provides a full line of practice management and back office services for physicians and hospital-owned physician groups throughout the USA. Services include: Revenue Cycle Management, Electronic Health Records, ACO and MSO development, practice management, transcription, call center, coding and compliance, IT infrastructure and support/facility development. We are located in National Harbor, MD, right outside of DC! Specialties: Physician Practice Management, Physician Services, ACO and MSO Development, Health Care Consulting and Project Management Job DescriptionDUTIES: Manage care Transitions from ER, Hospital and Nursing Home, coordinated with primary care provider staff and hospital staff Individual Care Planning for High Risk Patient and Prevention/wellness visits - coordinate efforts with payer/vendor care manager(s) team, primary care provider and his support team as well as community resources Coordination of Clinical Quality Improvement (CQI) Activities Coordinates, provides and documents patient education plan using standard based practice guidelines. Interacts effectively with patients, providing instruction and information, both written and verbal, as appropriate. Validates patients understanding of care/intervention recommendations. Provides training and updates on EMR usage and workflow NECESSARY ATTRIBUTES: Exceptional oral and written communication skills Strong interpersonal skills Demonstrated ability to collaborate effectively in team setting Basic computer skills Ability to effectively engage patients QualificationsQUALIFICATIONS: B.S. Degree in Nursing Current valid and unrestricted medical license in the State of Maryland (RN, Ph.D, LMSW/LCSW, MHC, LLP, LPC, etc.) 3 – 5 years of direct practice experience in settings that include inpatient, partial, and/or outpatient preferred Working knowledge of value based care models such as ACO’s, PCMH, and MACRA/MIPSAdditional InformationThe ideal candidate is someone who is always looking to do more, be a great asset to the team, and provide excellent patient care. He or she is a self-starter and does not wait to be directed to perform daily functions. In order to be successful in this position you have to be an outgoing and driven individual who is compassionate to the needs of others.