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Nurse Practitioner - IP
The nurse practitioner has responsibility for continuous, coordinated and comprehensive care of Health Spring members at designated institutional sites.
As coordinator of the care management team, the nurse practitioner assumes responsibility for collaborative practice with the member’s primary care physician, as that physician defines it. In addition, the nurse practitioner serves as medical liaison to the interdisciplinary staff and allied health providers, provides case management services, integrates components for care conferences and case presentations, and communicates information and reports to assure seamless delivery of services.
As a key member of the clinical team in the facility, the nurse practitioner provides preventive services, establishes medical diagnoses for both chronic and common acute problems, orders and interprets diagnostic tests, prescribes medications, refers to specialists and other providers as appropriate, provides basic emergency care if necessary, and acts as a resource to members, families, and staff.
ESSENTIAL DUTIES AND RESPONSIBILITIES
q Clinical Service Provision
ü Demonstrates both autonomy and proficiency in performance of comprehensive historical, social, physical, and functional assessments.
ü Pursues therapeutic interventions and diagnostic reasoning that reflect current, evidence-based nursing and medical knowledge and practice.
ü Collaborates with member’s physician to create a proactive plan of care focused on early prevention, detection and timely intervention.
ü Functions in a highly interactive mode, involving, as appropriate, physician, member, family, staff, peers, support teams, and preferred providers, while focusing on preventive activities and/or best possible restorative care.
ü Demonstrates a loyalty to and an involvement with assigned facility, as well as to HealthSpring, and integrates the two allegiances gracefully.
ü Communicates politely and calmly to other members of the care team, inspiring confidence in and respect for NP practice.
ü Adheres to HealthSpring standards of documentation and communication, including those related to the electronic medical record, Logician.
ü Demonstrates clear understanding of the purpose of Logician--to communicate referral and authorization information, integrate medical facts
and clinical data, and provide of current information for potential on-call
ü Reliably discharges on-call responsibilities.
ü Complies with the practice parameters of the state in which he or she practices.
q Case Management
ü Builds on the principles of geriatric care and HealthSpring clinical guidelines to plan proactively for optimal outcomes.
ü Works with the understanding that the IB NP role is equal parts medical management and case management.
ü Effectively listens to and communicates with all members of the care team, incorporates the ideas of the team to consensus, and manages the agreed-upon plan with confidence and discipline. Remains open to new ideas and demonstrate the flexibility, nimbleness and sense of humor that patient care of the elderly demands.
ü Utilizes critical thinking as to determine appropriate treatment and least restrictive placement, acknowledging a member’s right of self-determination.
ü Directs and collaborates with the care management team in ensuring that member transitions of care between various settings such as hospitals, skilled nursing, and rehabilitation facilities are managed appropriately.
ü Directs and collaborates with the IB care coordinator in performing as liaison between members, community-based resources, and health care institutions to assist in the coordination of benefits, such as Medicare and Medicaid that members are eligible to receive.
q Utilization Management
ü Facilitates a medically appropriate and effective plan of care to avoid unnecessary duplication of testing, prolonged hospitalization, iatrogenic illness, and fragmentation of care.
ü Demonstrates awareness of internal and external customers by following established HMO guidelines for pre-certification, authorization, nursing facility stays, specialty services, and use of authorized service vendors.
ü Strategizes with physician and management team to enhance cost effectiveness of services while addressing continuing needs of member, maximizing member’s health potential and supporting corporate mission.
ü Coordinates with social services for appropriate community and supportive resources across all settings of care.
ü While participating in periodic case review with the Regional Medical Director and Regional Director of Program Services demonstrates proficiency in the areas of clinical quality, customer satisfaction, and cost-effective care.
q Marketing Support
ü Demonstrates understanding of the marketing efforts necessary for growing Bravo Health membership.
ü Enthusiastically contributes ideas and leads to the marketing team.
ü Is cheerfully available to the Marketing team for participation in sales calls, family meetings, and other sales-generating events, and is articulate and persuasive in support of the HealthSpring program.
q Professional Development
ü Maintains enthusiastic leadership attitude with demonstrable commitment to the HealthSpring program.
ü Takes responsibility and substantiates rationales for specific interventions and overall plans.
ü Proactively pursues professional enhancement via self-assessment, peer evaluation, periodic care planning meetings with Medical Director and Director of Program Management, involvement in professional organizations, publication in professional journals, and continuing medical education.
CERTIFICATES, LICENSES, REGISTRATIONS
Currently licensed as an Adult, Family or Gerontological Nurse Practitioner in the state of practice, and meets HealthSpring credentialing requirements.
Are you a returning applicant?
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