Nurse Practitioner - Morgantown, WV

Overview

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Monogram Health is looking for skilled Nurse Practitioners and Physician Assistants eager for the opportunity to make a difference in patients' lives. The Advanced Practitioner at Monogram Health is a key member of an integrated Care Team which includes a Registered Nurse and a Social Worker. The patients we serve often struggle with multiple serious diseases. Our Nurse Practitioners and Physician Assistants help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.

• Conducts assessments, including comprehensive annual wellness exams on patients in the home and in the virtual environment.
• Counsels and educates patients and families about benefits and programs to help them live healthier lives.
• Documents medical information such as chief complaint, diagnoses, past medical, family and social history, review of systems, examinations, medications, allergies, assessment and plan.
• Coordinates care with primary care providers, specialists, and appropriate ancillary services.
• Completes all documentation and paperwork in a timely manner.
• Maintains quality of care standards as defined by the practice.
• This position will not be office-based but will be remote in the state in which employed and will require periodic training/meetings outside of that state.
• Delivers evidence-based, timely care to reduce avoidable hospitalizations, maximize quality of life, and place patient health and satisfaction first.
• Prescribes medications, orders tests, and collaborates with the patient’s Monogram physician.
• Performs effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily.
• Closely monitors care gaps and educates patients about preventive monitoring; coordinates with physician practices to schedule diagnostic testing.
• Assists patients with enrollment to access educational resources.
• Participates in integrated care team meetings and collaborates with related disciplines.
• Maintains knowledge of disease diagnosis and prevention; develops and implements treatment plans; follows up and evaluates patient status.

• Bilingual (English/Spanish) highly preferred
• Basic Life Support (BLS) certification required; company supports certification on onboarding.
• Active and unrestricted Registered Nurse and Nurse Practitioner or Physician Assistant license
• Board certified for appropriate licensure (NP: ANCC/AANP; PA: NCCPA)
• Current and unrestricted DEA certificate
• Ability to work autonomously without direct supervision
• Access to transportation, valid driver’s license, and car insurance
• Proficiency with medical instruments and equipment required for the role
• Knowledge of computer-based data management programs and medical records systems
• Effective communication with diverse partners, patients, families, physicians and community representatives
• Understanding of federal and state regulations including HIPAA and OSHA
• 2+ years of direct patient care experience
• Managed Care/IPA/Health Plan experience
• Experience conducting annual wellness visits or similar comprehensive visits virtually or in the home

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for patients with multiple chronic conditions. The organization focuses on a comprehensive, person-centered approach to health beyond a single disease, addressing chronic conditions such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team across nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues, review and prescribe medications, provide guidance and counseling on healthcare options, and assist with daily needs such as access to food, transportation, and financial assistance. The organization is available 24/7 to support patients in their homes.

Monogram Health’s model aims to improve patient outcomes and quality of life while reducing medical costs across the healthcare continuum.