Nurse Practitioner

Focus: Primary Care | Complex Care Management |Telehealth
Location: Ohio
Work Arrangement: Remote
Experience: 3 Years of Primary Care Experience
Education: Master’s Degree or Higher

We are seeking an experienced Nurse Practitioner (NP)to join a growing healthcare organization focused on delivering innovative,patient-centered care to medically complex populations throughout Ohio.

This is an opportunity to move beyond the traditional clinic setting and play a key role in a home-centered, value-based model of care
.The position focuses on proactive care management, early intervention, care coordination, and improving outcomes for patients who often require a higher level of clinical support.

The Nurse Practitioner will work as part of a collaborative interdisciplinary team that may include physicians, Nurse Practitioners,Registered Nurses, Licensed Clinical Social Workers, therapists, and other healthcare professionals.

Through telehealth, remote care management, and coordinated clinical services
, the team works closely with patients,families, caregivers, primary care providers, specialists, and health plan partners to help patients remain healthy and safely at home.

The patient population may include Medicaid and Dual Eligible members
, including individuals with:

• Complex chronic medical conditions.
• Traumatic brain injuries.
• Functional limitations.
• Medically complex and aging populations.
• Multiple chronic conditions requiring coordinated care.

The role is primarily virtual, with the potential for acollaborative office presence in a major Ohio metropolitan area as the organization continues to expand.

• Provide clinical care and ongoing patient management through telehealth andremote care technologies
  .
• Manageand coordinate care for medically complex adult and geriatric patient populations.
• Partner with physicians and interdisciplinary team members to develop and implement individualized care plans.
• Build strong relationships with patients, families, caregivers, primary care providers, specialists, and health plan partners.
• Monitor changes in patient health and intervene proactively to reduce avoidable emergency department visits and hospitalizations.
• Supportpatients through hospital admissions, discharges, and transitions back tothe home setting.
• Participate in advance care planning and goals-of-care discussions with patients and families.
• Participate in shared clinical triage and team-based support processes.
• Identify and address barriers to care, treatment adherence, and patient engagement.
• Supportquality improvement initiatives through accurate and timely clinical documentation.
• Contribute to HCC coding, risk adjustment, STAR, HEDIS, and quality-gap closure initiatives
  .
• Participate in the development of clinical best practices and contribute to the continued evolution of an innovative care model.
• Promote patient independence, safety, and improved quality of life through proactive care coordination.

• Master’sdegree or higher in Nursing or a related field.
• Current and active Nurse Practitioner license in Ohio
  , or ability to obtain
  
  Ohio licensure.
• Current
  Family Nurse Practitioner (FNP) or Adult/Adult-Gerontology Nurse Practitioner (AGNP) certification.
• Minimum3 years of primary care experience
  ; 3–5 years of Nurse Practitioner experience preferred.
• Abilityto practice autonomously within applicable scope of practice and maintain appropriate prescriptive authority.
• Experience caring for medically complex adult and/or geriatric patients
  .
• Experience with telehealth, virtual care, remote patient monitoring, or remote care management.
• Knowledge of or experience with HCC coding and risk adjustment
  .
• Familiarity with quality measures and programs, including STAR and HEDIS
  .
• Experience participating in advance care planning and…