What are the responsibilities and job description for the Nurse Practitioner position at Complex Care Solutions, LLC?
Complex Care Solutions specializes in delivering high-value in-home and virtual assessments for health plans nationwide.
We pride ourselves on member engagement aimed at evaluating current health status, gaps in care, potential health risks, and care management opportunities to drive better clinical outcomes.
Our visits give Providers the opportunity to spend a full hour with members, allowing them to capture a comprehensive picture of that individual's personal needs and requirements.
About Our Work
We are passionate about helping our local communities and making a difference in the lives of our members.
Responsibilities
- Stay up-to-date on CMS Regulations and NCQA HEDIS Guidelines.
- Familiarize yourself with evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA).
- Complete thorough reviews of assigned member populations, including timely completion and submission of required encounter documentation.
- Ensure accurate documentation of pertinent medical conditions in compliance with CMS/DHHS, Inovalon policy, and client requirements.
- Support physician/patient relationships and communicate assessment findings, recommendations, and follow-up timelines to primary care providers and health plans.
- Make general recommendations to members regarding their chronic conditions, such as recommended testing.
- Closing identified gaps in care, disease-specific or preventive.
- Recognize emergent or urgent situations and take appropriate action according to Inovalon policies and professional judgment.
- Maintain Point of Care (POC) Testing results and communicate accordingly.
- Comply with Inovalon's policies, procedures, and mission statement, adhering to confidentiality and HIPAA requirements.
- Fulfill responsibilities to achieve operational and financial success.
- Uphold separation of duties for applicable processes and procedures.
Qualifications
- Hold an active, un-encumbered license to practice nursing.
- Possess Nurse Practitioner Certification from ANCC or AANP in Family, Adult, Gerontology, or Emergency Medicine.
- Be Board Certified through AANP or ANCC.
- Maintain current CPR certification.
- Meet recommended Healthcare Personnel Requirements for vaccinations and preventive testing: Hepatitis B, Influenza, MMR, Pertussis, Tetanus, diphtheria, acellular pertussis (Tdap), Varicella, and Tuberculosis.
- Home Health experience is beneficial.
- Effectively communicate with elderly and chronically ill patients and families.
- Understanding of Medicare, Medicaid, and Health Plan benefit structures is beneficial.
- Able to multitask and possess excellent customer service skills.
- Bilingual or multilingual is a plus.
