Specialized ESRD Nurse Practitioner

Duo Health is a place where inspired people go to advance health equity in kidney care, one relationship at a time. Our team is comprised of leaders in value-based health care, technology and behavioral science who share a unique vision for reforming one of the most challenging areas of health care.

We are the relatives and friends of patients with chronic kidney disease (nearly 40M in the United States). We use our talents in service to them. We are united by this mission and by our passion for solving problems.

Our company uses modern technology and advanced clinical practice to liberate and enliven the cause of serving others. Our multidisciplinary care teams provide numerous opportunities for career advancement.

We respect, honor and support the contributions of our clinical and non-clinical teammates alike. We celebrate the diverse perspectives they bring to their work and to their lives. We believe those perspectives improve the quality of the relationships they build at Duo, enrich our company culture, and lead to better patient care.

Key to this mission is our belief that open, trusting relationships between patients and providers is the key to the success of clinical model.

If you are a person who delights in solving problems for others, if you are adaptable, if you are curious, if you are a good listener… we think there’s a role for you here.

Location: Mesa, AZ

Job :345

# of Openings:1

Company Mission

Duo Health is a value-based care organization focused on improving outcomes for patients living with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Our proprietary Health Mobilization™ platform connects multidisciplinary care teams with community nephrologists and other healthcare partners to deliver comprehensive, high-touch patient care.

Our interprofessional care teams comprised of Physician Assistants, Nurse Practitioners, social workers, and care navigators deliver high-touch, comprehensive care to a small panel of patients. Collaboration is central to our intensive psychosocial model, which includes assessment, medication management, social support, and behavioral health services. Duo Health is committed to building a workforce that reflects the diversity of the communities we serve, and we strongly encourage applicants whose work demonstrates a dedication to diversity, equity, and inclusion.

Job Description

The Specialized ESRD Advanced Practice Provider (APP) delivers comprehensive care to patients with ESRD and late-stage CKD. This role manages a dedicated panel of approximately 100–125 patients, providing primarily in-home visits and individualized clinical management. The APP collaborates with nephrologists, dialysis centers, and interdisciplinary care teams to improve patient outcomes, reduce avoidable hospitalizations, and coordinate care.

Duties and Responsibilities

• Manage a dedicated panel of 100–125 patients with ESRD and late-stage CKD (stages 4–5), primarily through in-home visits.
• Assess and manage vascular access, anemia, fluid status, hypertension, and other ESRD-related conditions.
• Coordinate with nephrologists and dialysis centers regarding treatment plans, dialysis adequacy, and patient needs.
• Manage complex medication regimens, including renal dose adjustments and avoidance of nephrotoxic medications.
• Identify transplant-eligible patients and initiate referrals as appropriate.
• Complete post-hospitalization follow-ups and coordinate transitions of care.
• Maintain accurate clinical documentation supporting HCC coding, risk adjustment, and quality measures.
• Participate in team huddles, care coordination, clinical training, and continuous improvement initiatives.
• Meet established goals related to quality, utilization, patient engagement, and clinical outcomes.
• Adhere to company policies, HIPAA regulations, and applicable clinical and regulatory requirements.
• Perfom other duties as assigned by supervisor.

Required Qualifications

• Active, unrestricted Nurse Practitioner or Physician Assistant license in the state of practice.
• Current national certification through an applicable certifying organization, such as ANCC, AANP, or NCCPA.
• Experience managing complex chronic conditions in primary care, geriatrics, or a related clinical setting.
• Strong clinical assessment, decision-making, and documentation skills.
• Proficiency in electronic health records (EHR).
• Strong communication and collaboration skills.
• Valid driver's license and reliable transportation for in-home patient visits.
• Commitment to…