What are the responsibilities and job description for the Nurse Practitioner position at Complex Care Solutions, LLC?
ComplexCare Solutions (CCS) 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 with a focus on driving better clinical outcomes.
Our visits give Providers the opportunity to spend a full hour with members, capturing a comprehensive picture of their personal needs and what is required to keep them in the home and out of the hospital.
About Us
We are calling on Nurse Practitioners who are passionate about helping their local communities. We care dearly about those we serve and need your help to make a difference in their lives.
Responsibilities
- Stay up-to-date on CMS Regulations and NCQA HEDIS Guidelines.
- Apply Evidence-based Clinical Practice Standards from reputable sources like the American Diabetes Association, American College of Cardiology, and American Heart Association.
- Complete comprehensive reviews of assigned member populations, including timely completion and submission of all required documentation.
- E nsure that all pertinent medical conditions are accurately documented in the medical record, following CMS/DHHS, Inovalon policy, and client requirements.
- Support physician-patient relationships through timely communication and adequate documentation of assessment findings and recommendations.
- Make general recommendations to improve members' knowledge of their chronic conditions, such as recommended testing.
- Closely identify and address gaps in care (disease-specific or preventive).
- Recognize emergent situations requiring escalation and take appropriate action based on professional judgment and ethical standards.
- Perform, document, and communicate results of Point of Care (POC) Testing.
- Maintain compliance with Inovalon policies, procedures, and mission statement, adhering to confidentiality and HIPAA requirements at all times.
- Fulfill responsibilities and duties provided by Inovalon for operational and financial success.
- Uphold separation of duties within job functions.
Qualifications
- Hold an active, unencumbered license to practice nursing.
- Be a certified Nurse Practitioner from either ANCC or AANP, with Family, Adult, Gerontology, or Emergency Medicine certification.
- Remain board-certified through AANP or ANCC.
- Maintain current CPR certification.
- Comply with vaccination and preventive testing recommendations prior to hire: Hepatitis B, Influenza, MMR, Pertussis, Tetanus, Varicella, and Tuberculosis.
- Prior experience in Home Health is beneficial.
- Demonstrate effective communication skills when interacting with elderly and chronically ill patients and families.
- Understand Medicare, Medicaid, and Health Plan benefit structures.
- Ability to multitask and provide excellent customer service.
- Bilingual or multilingual abilities are a plus.
