Nurse Practitioner - Scc Population Health​/Aco

Nurse Practitioner

As a Nurse Practitioner, you will play a crucial role in delivering high-quality healthcare services to patients across various age groups, but primarily Medicare and Medicare Advantage populations. Your primary responsibility will be to conduct comprehensive clinical assessments, develop treatment plans, develop care plans, perform telehealth TCM visits, and update problem lists, ensuring patient safety and well-being. You will collaborate with a multidisciplinary team to provide holistic care, addressing both physical and emotional health needs.

This position requires a strong commitment to patient education and advocacy, empowering individuals to make informed health decisions. Ultimately, your expertise will contribute to improved health outcomes and enhanced quality of life for the patients you serve.

• Master's degree in nursing from an accredited program.
• Current Nurse Practitioner certification in Family Medicine.
• Valid state nursing license and certification to practice as a Nurse Practitioner.
• Be able to work independently and with a multidisciplinary team as well as function/work effectively within an ever-changing quality-based care environment.
• Exhibit critical thinking skills, great time management, and organizational skills as well as quick learner

• Experience in geriatric care.
• Experience in quality-based care
• Experience in chronic care management
• Experience with Transitional Care Management
• Epic EHR experience

• Conduct thorough patient assessments and evaluations to determine health status and needs, especially those with multiple chronic conditions.
• Develop and implement individualized care plans in collaboration with patients and healthcare teams.
• Manage and treat acute and chronic conditions, including pain management strategies.
• Educate patients and their families on health maintenance, disease prevention, and treatment options.
• Monitor patient progress and adjust treatment plans as necessary to ensure optimal outcomes.
• Enroll new CCM members by explaining the program and creating care plans.
• Perform TCM services via telehealth as needed.
• Collaborate with Director of Population Health/ACO and other staff to help SCRMC and providers achieve, master, and obtain excellent or above average quality scores.
• Perform any other responsibilities as needed by SCRMC or Population Health Department.

• Promote patient safety, quality outcomes, and regulatory compliance.
• Maintain professional competency through continuing education and certification requirements.
• Collaborate effectively with providers, care coordinators, and interdisciplinary team members.
• Support population health initiatives and quality improvement efforts.
• Demonstrate professionalism, accountability, and effective communication.

• Ability to sit, stand, walk, bend, reach, and perform clinical duties for extended periods.
• Manual dexterity sufficient to operate clinical equipment and computer systems.
• Ability to lift, move, push, or pull up to 50 pounds independently and more with assistance.
• Adequate vision, hearing, and communication skills to safely perform job duties.

All candidates must be able to perform the essential functions of this position. The Americans with Disabilities Act (ADA) requires that reasonable accommodations be made for qualified individuals to assist in performing the essential functions of the position.

South Central Regional Medical Center is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, or any other protected status under applicable law.