All jobs

Vitability Health Mahwah, NJ

6 days ago

Home visitation assessment personal MA/LPN/CNA Spanish speaking

Vitability Health is leading the change in how providers deliver remote care. Our next-generation Remote Patient Monitoring (RPM) program enables medical teams to provide safe, effective remote care that improves patient outcomes, lowers patient's medical expenses, empowers patients to be fearless, and live longer lives. We are a team of dedicated, mission-driven pros who seek to work with colleagues who inspire us and share our mission and core values Qualifications Bilingual, spanish speaking Experience with Medicare patients Interest in professional leadership growth and development opportunities with a growing organization Technically savvy and comfortable using tools such as iPads for charting Interest in operating in a new, exciting clinical program and become an integral player in the development of processes and best practices in caring for RPM patients Strong verbal and written communication skills Valid driver’s license with a clean driving record Ability to lift and carry equipment up to 20 pounds Comfortable driving to patient’s homes in NYC and providing care Comfortable seeing patients independently and delivering a positive experience Full COVID-19 vaccination is a requirement for this position. Medical and religious exemptions may be granted with proper documentation. Heal will adhere to all federal, state, and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance. Responsibilities As a care team member you will perform routine primary care nursing tasks, including: Vital signs Point of care tests (glucometer, etc) Maintain patient medical records Documentation consistent with state regulation As a care team member, you love utilizing motivational communication techniques and strategies, to help drive positive health behavior change and improved patient outcomes The Practical Nurse (LPN) plays a vital role in educating patients on how to manage their acute or chronic medical conditions, with a goal to maintain health, wellness, and to avoid emergency room utilization and hospitalization Significantly impact longitudinal patient engagement in RPM program(s) Provide preventive health and disease management education and coaching

Director of Nursing Hospice

Vitability Health Howell Township, NJ

We are seeking an experienced Director of Nursing (RN) to lead and oversee all clinical operations for our growing hospice organization. The ideal candidate is a strong clinical leader with hands-on hospice experience, a deep understanding of Medicare Conditions of Participation, and the ability to build, mentor, and manage an interdisciplinary team. Hospice experience is required. This is not an entry-level leadership role. Responsibilities: Provide clinical leadership and oversight of all hospice nursing services Ensure compliance with federal and state hospice regulations and Medicare CoPs Supervise and support RNs, LPNs, aides, and clinical staff Oversee care plans and interdisciplinary team meetings Maintain quality assurance and performance improvement programs Ensure accurate and timely clinical documentation Participate in survey readiness and regulatory audits Collaborate with the Administrator and Medical Director to ensure high-quality patient care Assist with hiring, onboarding, and clinical training Qualifications: Active Registered Nurse (RN) license in NJ Minimum 2–3 years hospice experience required Prior hospice leadership or supervisory experience strongly preferred Strong knowledge of hospice regulations, compliance, and documentation standards Experience with EMR systems Excellent communication and team leadership skills What We Offer: Competitive salary Supportive leadership environment Opportunity to help build and grow a high-quality hospice program Benefits package If you are a passionate hospice RN leader who values patient-centered care and strong clinical standards, we would love to speak with you.

1 week ago

Nurse practitioner

Vitability Health NY

GENERAL JOB SUMMARY An exempt clinical position where the nurse practitioner (NP) is responsible for providing direct patient care. The NP participates as a leader of the skilled nursing facility (SNF) care team. Visits managed care and fee-for-service patients at skilled and long-term levels of care in designated SNFs facilities. Provides appropriate evidence-based geriatric medicine. Coordinates care with hospitalists, primary care physicians and care managers. Makes home visits as directed by the medical staff to meet patient needs and provide continuity of care. ESSENTIAL JOB FUNCTIONS Maintains privileges in multiple Nursing Homes as directed by ACA Maintains license and malpractice insurance Consults supervising attending as needed Documents patient visits electronically at least 90% of the time Participates in documentation and other quality improvement programs Available via phone weekdays 8am- 7pm and when on call. Will reviews, approves, and modifies admission orders Creates a detailed admit note for each admission within 24 hours of patient admission to SNF, including medication reconciliation Initiates/documents Advanced Directives Determines if Health Care Proxy status is correct and invoke if appropriate On weekends, takes call for admissions and see new patients within 24 hours of admission on a rotating basis with other practitioners in the program. Daily Visits Initiates and review orders, including medications, on a daily basis Reviews labs, radiology reports, and consults on all patients Talks to and examines each assigned skilled-level patient on daily rounds Monday through Friday Writes at least one daily progress note for each skilled patient Assess patient’s medical stability daily. Consults/coordinates with specialists as needed Addresses acute mental status changes via non-pharmacologic or pharmacologic measures, consultation or transfer Coordinates/assess rehab progress on a daily basis Discusses concerns with the patient, family, rehab, and case management. Educates patient and family members regarding acute and chronic illness management Attends family meetings as necessary Assists PCP’s that participate in SNF management Informs attending and/or ACA medical director of significant changes in medical condition Participates in weekly utilization meetings, collaborating with the SNF care team and ACA care managers Coordinates with PCP’s, Hospitalists, ACA Medical Directors and Case Managers Performs home visits on selected patients Addresses /coordinates any legal issues. Discharge Develops a discharge plan utilizing input from case management and rehab. Identify barriers to discharge Creates a detailed discharge summary for each admission on all patients, including medication reconciliation, and sends to the PCP at the time of SNF discharge Ensures that patients have all appropriate drug and DME prescriptions at discharge Coordinates visits with the PCP post-discharge Discharges summary to be sent to the PCP at discharge Updates all patients in Care Screen™ before discharge Coordinates transition from skilled to long term placement. Long-Term Care Assists case management in the evaluation of selected long term patients Follows “new” long term patients every 30 days Assists the attending physician with management for complex long-term patients Qualifications EDUCATION AND EXPERIENCE License to practice as a Registered Nurse and a certificate to practice as a Nurse Practitioner issued by the State Board of Registered Nursing. Geriatrics specialty certification preferred Minimum of three years of clinical nursing experience preferred, including work in a skilled nursing facility. 20 days PTO, Health insurance, 401 k %2, Malpractice insurance.

Healthcare

Vitability Health Union, NJ

1 week ago

Remote Chronic Care Manager (NP/PA) Vitability Health of New Jersey

About Us: Vitability Health of New Jersey is dedicated to providing high-quality, patient-centered care to individuals with chronic health conditions. Our mission is to enhance the well-being of our patients through comprehensive, personalized care management. Job Description: We are seeking a highly skilled and compassionate Chronic Care Manager Nurse Practitioner or Physician Assistant to join our team. The ideal candidate will have a strong background in chronic care management and patient monitoring. This role requires excellent communication and organizational skills, as well as the ability to delegate tasks effectively to care coordinators. This position offers the flexibility to work remotely. Key Responsibilities: Provide chronic care management services to patients with chronic conditions. Develop and implement individualized care plans in collaboration with patients, their families, and healthcare providers. Monitor patient progress, assess their needs, and make necessary adjustments to care plans. Educate patients and their families on disease management, medication adherence, and lifestyle modifications. Utilize telehealth technology to conduct regular follow-ups and remote monitoring. Delegate tasks to care coordinators and oversee their performance to ensure the highest quality of care. Maintain accurate and up-to-date patient records in accordance with HIPAA regulations. Collaborate with interdisciplinary teams to coordinate care and ensure continuity. Perform comprehensive health assessments to identify patient needs and establish care goals. Facilitate medication reconciliation and ensure patients understand their medication regimens. Coordinate and schedule appointments, tests, and procedures to ensure timely and efficient care. Assist patients with accessing community resources and support services. Develop and implement strategies to reduce hospital readmissions and emergency room visits. Provide support and counseling to patients and their families regarding disease processes and care plans. Track and report on quality metrics and patient outcomes to ensure program effectiveness. Stay current with best practices and advancements in care management. Qualifications: Nurse Practitioner or Physician Assistant license in the state of New Jersey or a Compact License. Experience in chronic care management is required. Acute care experience is required. Strong leadership and delegation skills. Excellent communication and interpersonal skills. Proficiency in using electronic health records (EHR) and telehealth platforms. Ability to work independently and as part of a multidisciplinary team. Compassionate and patient-centered approach to care.

Vitability Health Marlton, NJ

1 week ago

House Call Advanced Nurse Practitioner camden New jersey

APN/PA to Perform House Calls in Camden County Job Summary: Stella Healthcare is seeking a compassionate and experienced Nurse Practitioner (NP) or Physician Assistant (PA) to provide high-quality, patient-centered care in the comfort of patients' homes. The ideal candidate will have experience in primary care, geriatrics, or chronic disease management and will be responsible for conducting comprehensive assessments, developing personalized care plans, and coordinating with interdisciplinary healthcare teams to ensure optimal patient outcomes. Key Responsibilities: Conduct in-home patient visits to assess medical conditions, provide treatment, and offer patient education. Perform comprehensive physical exams, medication management, and health screenings. Develop and implement individualized treatment plans in collaboration with the patient’s primary care physician and care team. Monitor and manage chronic conditions such as diabetes, hypertension, and heart disease. Provide palliative and end-of-life care discussions as appropriate. Educate patients and caregivers on disease prevention, medication adherence, and lifestyle modifications. Document all patient interactions accurately and timely in the electronic medical record (EMR) system. Collaborate with physicians, nurses, social workers, and other healthcare professionals to coordinate care and improve patient outcomes. Identify and address social determinants of health that may impact patient well-being. Respond promptly to patient inquiries and urgent medical needs. Ensure compliance with all federal, state, and local regulations, as well as company policies and procedures. Qualifications: Education: Master’s degree from an accredited Nurse Practitioner or Physician Assistant program. Licensure: Current and unrestricted NP or PA license in the state of practice. Skills: Strong clinical assessment and diagnostic skills. Excellent communication and interpersonal skills. Ability to work independently and manage time effectively. Proficiency in EMR systems and basic technology use. Compassionate and patient-centered approach to care. Requirements: Valid driver’s license and reliable transportation for home visits. Ability to travel within the designated service area. CPR/BLS certification (required). Benefits: Competitive salary based on experience. Flexible work schedule. Paid time off (PTO) and holidays. Continuing education reimbursement. Mileage reimbursement. Opportunity to make a meaningful impact in the community.

CMA

2 weeks ago

Home visitation assessment personal Certified Medical Assistant

Vitability Health is leading the change in how providers deliver remote care. Our program enables medical teams to provide safe, effective remote care that improves patient outcomes, lowers patient's medical expenses, empowers patients to be fearless, and live longer lives. We are a team of dedicated, mission-driven pros who seek to work with colleagues who inspire us and share our mission and core values Qualifications Bilingual a plus Experience with Medicare patients Interest in professional leadership growth and development opportunities with a growing organization Technically savvy and comfortable using tools such as iPads for charting Interest in operating in a new, exciting clinical program and become an integral player in the development of processes and best practices in caring for RPM patients Strong verbal and written communication skills Valid driver’s license with a clean driving record Ability to lift and carry equipment up to 20 pounds Comfortable driving to patient’s homes in NYC and providing care Comfortable seeing patients independently and delivering a positive experience Full COVID-19 vaccination is a requirement for this position. Medical and religious exemptions may be granted with proper documentation. Heal will adhere to all federal, state, and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance. Responsibilities As a care team member you will perform routine primary care nursing tasks, including: Vital signs Point of care tests (glucometer, etc) Maintain patient medical records Documentation consistent with state regulation As a care team member, you love utilizing motivational communication techniques and strategies, to help drive positive health behavior change and improved patient outcomes The Practical Nurse (LPN) plays a vital role in educating patients on how to manage their acute or chronic medical conditions, with a goal to maintain health, wellness, and to avoid emergency room utilization and hospitalization Significantly impact longitudinal patient engagement in RPM program(s) Provide preventive health and disease management education and coaching

LPN

2 weeks ago

Home visitation assessment personal MA/LPN/RN russian speaking

Vitability Health Moorestown, NJ

Vitability Health is leading the change in how providers deliver remote care. Our next-generation Remote Patient Monitoring (RPM) program enables medical teams to provide safe, effective remote care that improves patient outcomes, lowers patient's medical expenses, empowers patients to be fearless, and live longer lives. We are a team of dedicated, mission-driven pros who seek to work with colleagues who inspire us and share our mission and core values Qualifications Bilingual russian speaking Experience with Medicare patients Interest in professional leadership growth and development opportunities with a growing organization Technically savvy and comfortable using tools such as iPads for charting Interest in operating in a new, exciting clinical program and become an integral player in the development of processes and best practices in caring for RPM patients Strong verbal and written communication skills Valid driver’s license with a clean driving record Ability to lift and carry equipment up to 20 pounds Comfortable driving to patient’s homes in NYC and providing care Comfortable seeing patients independently and delivering a positive experience Full COVID-19 vaccination is a requirement for this position. Medical and religious exemptions may be granted with proper documentation. Heal will adhere to all federal, state, and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance. Responsibilities As a care team member you will perform routine primary care nursing tasks, including: Vital signs Point of care tests (glucometer, etc) Maintain patient medical records Documentation consistent with state regulation As a care team member, you love utilizing motivational communication techniques and strategies, to help drive positive health behavior change and improved patient outcomes The MA/LPN/RN plays a vital role in educating patients on how to manage their acute or chronic medical conditions, with a goal to maintain health, wellness, and to avoid emergency room utilization and hospitalization Significantly impact longitudinal patient engagement in RPM program(s) Provide preventive health and disease management education and coaching

Nurse Practitioner In Home Primary and Acute Visits

Nurse Practitioner – In-Home Primary and Acute Care | No Nights/Weekends | $120K+ Burlington & Camden County | 4 or 5 Day Schedule | W2 or 1099 Options Why This Role Stands Out This is not a traditional home health role. You’ll practice true primary care/acute care in the home , supported by a full team—without the burnout of clinic volume. No nights, no weekends, no holidays Flexible 4 or 5 day schedule Starting salary $120,000+ W2 or 1099 options available Mileage reimbursement Structured scheduling + optimized daily routes Every patient you see is enrolled in our Chronic Care Management Program and already supported by a dedicated Care Manager (RN) and Social Worker who you will have direct access to. How This Role Works This is an add-on care model for patients already enrolled in Stella Healthcare’s remote chronic care management program. That means: Patients are already engaged and monitored You walk into visits with real context—not cold starts You have a team actively managing the patient between visits You focus on clinical care , while your team helps execute the rest. What You’ll Do Conduct in-home primary care visits and comprehensive assessments Manage chronic conditions (diabetes, hypertension, CHF, etc.) Perform physical exams, medication management, and screenings Draw labs in the home when needed Develop and adjust care plans in coordination with the care team Delegate follow-up needs to RN/SW team for execution Educate patients and caregivers on treatment and prevention Document visits in EMR accurately and efficiently Territory Primary coverage: Burlington and Camden County Occasional coverage in surrounding counties Outlier visits are intentionally scheduled and clustered to maximize efficiency What We’re Looking For Licensed Nurse Practitioner (NP) in the state of practice Strong experience in primary care and chronic disease management Comfortable working independently in a field-based role Ability to perform basic in-home procedures (including lab draws) Strong clinical judgment and patient communication skills Support Structure You are fully supported so you can focus on care: Dedicated RN Care Manager + Social Worker for every patient Access to one of our Stella Healthcare CCM Providers for oversight Scheduler who handles appointment setting, reminder calls, and route optimization Collaborative care model with clear delegation pathways Requirements Valid driver’s license and reliable transportation Willingness to travel within service area CPR/BLS certification

RN

Vitability Health Florence, AL

3 weeks ago

Fully Remote Chronic Care Manager (RN)

Chronic Care Manager (RN) Vitability Health of New Jersey Remote Position Our Mission At Vitability Health of New Jersey, we believe great care goes beyond checklists and charts—it’s about relationships, trust, and walking alongside patients as they navigate life with chronic conditions. Our mission is to improve quality of life through thoughtful, personalized care that meets patients where they are and supports them every step of the way. About the Role We are looking for a compassionate and experienced Chronic Care Manager (RN) who is passionate about caring for patients over the long term. In this role, you will build meaningful relationships with patients, help them better understand and manage their health, and serve as a steady, trusted presence in their care journey. This position is ideal for a nurse who values connection, collaboration, and purpose—and who enjoys using clinical expertise to make a real difference, all while working remotely. What You’ll Do Provide ongoing chronic care management to a caseload of patients living with multiple chronic conditions Develop and maintain personalized care plans that reflect each patient’s goals, challenges, and needs Conduct comprehensive assessments to understand medical, social, and lifestyle factors affecting health Monitor patient progress, identify changes early, and adjust care plans to support better outcomes Educate and encourage patients and their families on disease management, medications, and healthy lifestyle choices Use telehealth and remote monitoring to stay connected with patients between visits Partner with Care Navigators (social workers) by delegating tasks and supporting their work to ensure seamless, high-quality care Collaborate with providers and interdisciplinary team members to promote continuity and alignment across care Support medication reconciliation and help patients feel confident in understanding their treatment plans Assist with coordinating appointments, tests, and follow-ups to reduce barriers to care Help patients access community resources and support services that enhance overall well-being Work proactively to reduce hospital readmissions and emergency department visits through consistent engagement Maintain clear, timely, and compliant documentation in the EHR in accordance with HIPAA and CMS guidelines Track patient outcomes and quality measures to help strengthen and grow our care management programs Stay informed on best practices and evolving standards in chronic care management What We’re Looking For Active Registered Nurse (RN) license in New Jersey or a valid Compact RN License Experience in Chronic Care Management (CCM) Required acute care nursing experience A caring, patient-centered approach with a genuine desire to support patients over time Strong communication and organizational skills Ability to lead and collaborate with care coordinators in a supportive, team-oriented way Comfort using EHR systems, telehealth platforms, and remote patient monitoring tools Ability to work independently while staying connected to a collaborative care team Love this direction. This is exactly where you win great nurses back to meaningful work. Why Vitability Health At Vitability Health, we care deeply about our patients—and just as deeply about the people who care for them. We’ve intentionally built a work environment that values balance, trust, and sustainability, so our nurses can do their best work without sacrificing their well-being. Here’s what you can expect: Fully Remote Work Work from the comfort of your home—no commute, no traffic, and no unnecessary stress. We believe great care can happen anywhere. True Work/Life Balance This role follows a strict 9:00–5:00 schedule with no nights, weekends, and very limited on-call expectations . When your workday ends, your time is yours. Paid Holidays Off We observe major holidays so you can rest, recharge, and spend meaningful time with family and loved ones. Paid Time Off (PTO) PTO is available because rest isn’t a luxury—it’s essential to providing great care. Monthly Work Flexibility We understand life happens. Our team is supported with built-in flexibility each month to attend appointments, family needs, or personal responsibilities without guilt. Purpose-Driven Work Build long-term relationships with patients and see the impact of your care over time—no rushed encounters, no revolving doors. Supportive, Team-Oriented Culture You’ll be part of a collaborative care team that values communication, respect, and shared success. A Sustainable Nursing Career This role is designed for nurses who want to continue making a difference—without burnout, physical strain, or emotional exhaustion.

Hospice RN

Vitability Health Howell Township, NJ

We are seeking an experienced RN to lead and oversee all clinical operations for our growing hospice organization. The ideal candidate is a strong clinical leader with hands-on hospice experience, a deep understanding of Medicare Conditions of Participation, and the ability to build, mentor, and manage an interdisciplinary team. Hospice experience is required. This is not an entry-level leadership role. Responsibilities: Provide clinical leadership and oversight of all hospice nursing services Ensure compliance with federal and state hospice regulations and Medicare CoPs Supervise and support RNs, LPNs, aides, and clinical staff Oversee care plans and interdisciplinary team meetings Maintain quality assurance and performance improvement programs Ensure accurate and timely clinical documentation Participate in survey readiness and regulatory audits Collaborate with the Administrator and Medical Director to ensure high-quality patient care Assist with hiring, onboarding, and clinical training Qualifications: Active Registered Nurse (RN) license in NJ Minimum 2–3 years hospice experience required Prior hospice leadership or supervisory experience strongly preferred Strong knowledge of hospice regulations, compliance, and documentation standards Experience with EMR systems Excellent communication and team leadership skills What We Offer: Competitive salary Supportive leadership environment Opportunity to help build and grow a high-quality hospice program Benefits package If you are a passionate hospice RN leader who values patient-centered care and strong clinical standards, we would love to speak with you.

RN

Vitability Health Florence, AL

1 month ago

Remote Registered Nurse Chronic Care Management

Chronic Care Manager (RN) Vitability Health of New Jersey Remote Position Our Mission At Vitability Health of New Jersey, we believe great care goes beyond checklists and charts—it’s about relationships, trust, and walking alongside patients as they navigate life with chronic conditions. Our mission is to improve quality of life through thoughtful, personalized care that meets patients where they are and supports them every step of the way. About the Role We are looking for a compassionate and experienced Chronic Care Manager (RN) who is passionate about caring for patients over the long term. In this role, you will build meaningful relationships with patients, help them better understand and manage their health, and serve as a steady, trusted presence in their care journey. This position is ideal for a nurse who values connection, collaboration, and purpose—and who enjoys using clinical expertise to make a real difference, all while working remotely. What You’ll Do Provide ongoing chronic care management to a caseload of patients living with multiple chronic conditions Develop and maintain personalized care plans that reflect each patient’s goals, challenges, and needs Conduct comprehensive assessments to understand medical, social, and lifestyle factors affecting health Monitor patient progress, identify changes early, and adjust care plans to support better outcomes Educate and encourage patients and their families on disease management, medications, and healthy lifestyle choices Use telehealth and remote monitoring to stay connected with patients between visits Partner with Care Navigators (social workers) by delegating tasks and supporting their work to ensure seamless, high-quality care Collaborate with providers and interdisciplinary team members to promote continuity and alignment across care Support medication reconciliation and help patients feel confident in understanding their treatment plans Assist with coordinating appointments, tests, and follow-ups to reduce barriers to care Help patients access community resources and support services that enhance overall well-being Work proactively to reduce hospital readmissions and emergency department visits through consistent engagement Maintain clear, timely, and compliant documentation in the EHR in accordance with HIPAA and CMS guidelines Track patient outcomes and quality measures to help strengthen and grow our care management programs Stay informed on best practices and evolving standards in chronic care management What We’re Looking For Active Registered Nurse (RN) license in New Jersey or a valid Compact RN License Experience in Chronic Care Management (CCM) Required acute care nursing experience A caring, patient-centered approach with a genuine desire to support patients over time Strong communication and organizational skills Ability to lead and collaborate with care coordinators in a supportive, team-oriented way Comfort using EHR systems, telehealth platforms, and remote patient monitoring tools Ability to work independently while staying connected to a collaborative care team Love this direction. This is exactly where you win great nurses back to meaningful work. Why Vitability Health At Vitability Health, we care deeply about our patients—and just as deeply about the people who care for them. We’ve intentionally built a work environment that values balance, trust, and sustainability, so our nurses can do their best work without sacrificing their well-being. Here’s what you can expect: Fully Remote Work Work from the comfort of your home—no commute, no traffic, and no unnecessary stress. We believe great care can happen anywhere. True Work/Life Balance This role follows a strict 9:00–5:00 schedule with no nights, weekends, and very limited on-call expectations . When your workday ends, your time is yours. Paid Holidays Off We observe major holidays so you can rest, recharge, and spend meaningful time with family and loved ones. Paid Time Off (PTO) PTO is available because rest isn’t a luxury—it’s essential to providing great care. Monthly Work Flexibility We understand life happens. Our team is supported with built-in flexibility each month to attend appointments, family needs, or personal responsibilities without guilt. Purpose-Driven Work Build long-term relationships with patients and see the impact of your care over time—no rushed encounters, no revolving doors. Supportive, Team-Oriented Culture You’ll be part of a collaborative care team that values communication, respect, and shared success. A Sustainable Nursing Career This role is designed for nurses who want to continue making a difference—without burnout, physical strain, or emotional exhaustion.

7 months ago

Nurse practitioner

GENERAL JOB SUMMARY An exempt clinical position where the nurse practitioner (NP) is responsible for providing direct patient care. The NP participates as a leader of the skilled nursing facility (SNF) care team. Visits managed care and fee-for-service patients at skilled and long-term levels of care in designated SNFs facilities. Provides appropriate evidence-based geriatric medicine. Coordinates care with hospitalists, primary care physicians and care managers. Makes home visits as directed by the medical staff to meet patient needs and provide continuity of care. ESSENTIAL JOB FUNCTIONS Maintains privileges in multiple Nursing Homes as directed by ACA Maintains license and malpractice insurance Consults supervising attending as needed Documents patient visits electronically at least 90% of the time Participates in documentation and other quality improvement programs Available via phone weekdays 8am- 7pm and when on call. Will reviews, approves, and modifies admission orders Creates a detailed admit note for each admission within 24 hours of patient admission to SNF, including medication reconciliation Initiates/documents Advanced Directives Determines if Health Care Proxy status is correct and invoke if appropriate On weekends, takes call for admissions and see new patients within 24 hours of admission on a rotating basis with other practitioners in the program. Daily Visits Initiates and review orders, including medications, on a daily basis Reviews labs, radiology reports, and consults on all patients Talks to and examines each assigned skilled-level patient on daily rounds Monday through Friday Writes at least one daily progress note for each skilled patient Assess patient’s medical stability daily. Consults/coordinates with specialists as needed Addresses acute mental status changes via non-pharmacologic or pharmacologic measures, consultation or transfer Coordinates/assess rehab progress on a daily basis Discusses concerns with the patient, family, rehab, and case management. Educates patient and family members regarding acute and chronic illness management Attends family meetings as necessary Assists PCP’s that participate in SNF management Informs attending and/or ACA medical director of significant changes in medical condition Participates in weekly utilization meetings, collaborating with the SNF care team and ACA care managers Coordinates with PCP’s, Hospitalists, ACA Medical Directors and Case Managers Performs home visits on selected patients Addresses /coordinates any legal issues. Discharge Develops a discharge plan utilizing input from case management and rehab. Identify barriers to discharge Creates a detailed discharge summary for each admission on all patients, including medication reconciliation, and sends to the PCP at the time of SNF discharge Ensures that patients have all appropriate drug and DME prescriptions at discharge Coordinates visits with the PCP post-discharge Discharges summary to be sent to the PCP at discharge Updates all patients in Care Screen™ before discharge Coordinates transition from skilled to long term placement. Long-Term Care Assists case management in the evaluation of selected long term patients Follows “new” long term patients every 30 days Assists the attending physician with management for complex long-term patients Qualifications EDUCATION AND EXPERIENCE License to practice as a Registered Nurse and a certificate to practice as a Nurse Practitioner issued by the State Board of Registered Nursing. Geriatrics specialty certification preferred Minimum of three years of clinical nursing experience preferred, including work in a skilled nursing facility. 20 days PTO, Health insurance, 401 k %2, Malpractice insurance.

7 months ago

Nurse practitioner