Advanced Practice Clinician (NP, PA) - Home Based, Waterbury, CT 06701
Company: Avidity Exchange
Location: New Haven
Posted on: January 13, 2021
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Job Description:
Advanced Practice Clinician (NP, PA) - Home Based Nurse:
Advanced Practice Nurse: Home Health Waterbury, CT 06701 Full-time
licenses and certifications BLS, DEA, Driver's License, NC License,
PA-C , AANP care settings Home Health Job Title Advanced Practice
Clinician (NP, PA) - Home Based Care Job Description In this role,
you will provide direct services to members, who face economic and
social challenges in addition to having mental and physical health
needs, through our innovative care model. You will a mobile care
provider, extending out in the surrounding neighborhood and
community. It is integral to our care model that we meet people
where they are, both physically and emotionally. Given this, your
work will frequently take you out into the field and surrounding
community to provide care in settings that work best for our
members. As an Advanced Practice Clinician, you will work with a
panel of members to improve their health holistically through
longitudinal primary care, care management, and care coordination.
You will provide a necessary bridge to specialty care, homecare
services, and other facility services. You will provide
comprehensive care management, chronic disease management, urgent
community-based primary care visits, preventative care and
wellness, liaison with relevant other providers around behavioral
health and long term service and support needs, and the provision
of palliative care. Additionally, you will provide clinical support
to our team of Community Health Partners, who will serve as members
main point-of-contact and coordinator. You will work alongside, and
will be supported by, a care team associated with each member,
whose work is focused around a Member Action Plan (MAP). Required
Skills and Experience - NP or PA with licensure in good standing in
Connecticut - AANC or AANP certification for NPs - Connecticut
Controlled Substance Registration - DEA Controlled Substances
Registration - Certified in Basic Life Support for Healthcare
Providers - Experience providing clinical services to individuals
with co-occurring chronic medical and behavioral health conditions,
and have an interest in serving complex, vulnerable, and disabled
populations. - Proven skills, knowledge base, and judgment
necessary for independent clinical decision-making. - Organized,
efficient, independent self-starter and problem-solver, a leader, a
strategic thinker, and a mentor, who is excited about the big
picture of whole community health. - Excited about how technology
can support your work and help drive the ongoing evaluation toward
new and better care. - Experience caring for seniors in a
low-income community or in a community health setting. - Experience
working collaboratively with an interdisciplinary care team, and
specifically working alongside community health workers or care
coordination staff. - Unrestricted Connecticut Drivers License and
vehicle for daily usage - Bilingual and bicultural What You Need to
Know - Follow a panel of members for primary care, and provide
clinical support to the interdisciplinary care teams. - Interface
with specialists, hospitals, and community based organizations to
promote an understanding of the organization's model, facilitate
collaboration, and promote shared decision making. - Perform
episodic urgent medical/behavioral health visits and/or telephone
calls for members on your panel to ensure that timely and
appropriate medical care in order to avoid emergency department
visit or hospitalization. - Perform post-discharge visits for
members who have been recently discharged from either an acute care
facility or skilled nursing facility to decrease risk of
readmission; perform detailed medication reconciliation, and assure
that appropriate long term services are in place. - Monitor and
address clinical quality gaps in care. - Participate equally in all
call responsibilities. - Work daily within our custom-built care
facilitation platform, which will enable you to collect data,
organize information, track tasks, and communicate with staff,
members, and family. This platform is being built for a mobile
workforce, and you will use our technology in the field, provide
feedback to the product development team, and, over time, become
part of a super-user group to assist in onboarding and supporting
others. - Attends external meetings and activities, and maintains
professional credentialing and CME standards. perks Professional
development opportunities Full benefits 401k The role: In this
role, you will provide direct services to members, who face
economic and social challenges in addition to having mental and
physical health needs, through our innovative care model. You will
be a mobile care provider, extending out in the surrounding
neighborhood and community. It is integral to our care model that
we meet people where they are, both physically and emotionally.
Given this, your work will frequently take you out into the field
and surrounding community to provide care in settings that work
best for our members. As an Advanced Practice Clinician, you will
work with a panel of members to improve their health holistically
through longitudinal primary care, care management, and care
coordination. You will provide a necessary bridge to specialty
care, homecare services, and other faility services. You will
provide comprehensive care management, chronic disease management,
urgent community-based primary care visits, preventative care and
wellness, liaison with relevant other providers around behavioral
health and long term service and support needs, and the provision
of palliative care. Additionally, you will provide clinical support
to our team of Community Health Partners, who will serve as members
main point-of-contact and coordinator. You will work alongside, and
will be supported by, a care team associated with each member,
whose work is focused around a Member Action Plan (MAP). You will:
- Follow a panel of members for primary care, and provide clinical
support to the interdisciplinary care teams. - Interface with
specialists, hospitals, and community based organizations to
promote an understanding of clients model, facilitate
collaboration, and promote shared decision making. - Perform
episodic urgent medical/behavioral health visits and/or telephone
calls for members on your panel to ensure that timely and
appropriate medical care in order to avoid emergency department
visit or hospitalization. - Perform post-discharge visits for
members who have been recently discharged from either an acute care
facility or skilled nursing facility to decrease risk of
readmission; perform detailed medication reconciliation, and assure
that appropriate long term services are in place. - Foster lasting
and trusting relationships to assist members in achieving goals,
identifying new needs, and coordinating care. - Monitor and address
clinical quality gaps in care. - Participate equally in all call
responsibilities. - Go above and beyond to connect with members and
partners in a non-judgmental, respectful and empathic manner, to
meet their needs, and to provide feedback to the system as a whole
as we strive to do better every day. - Work daily within our
custom-built care facilitation platform, which will enable you to
collect data, organize information, track tasks, and communicate
with staff, members, and family. This platform is being built for a
mobile workforce, and you will use our technology in the field,
provide feedback to the product development team, and, over time,
become part of a super-user group to assist in onboarding and
supporting others. - Attends external meetings and activities, and
maintains professional credentialing and CME standards. - Act as a
mentor to other team members to help promote accountability,
reliability, and independence among the other team members. Offer
teaching opportunities and in-services as able. - Assists
management and leadership with the development, refinement, and
enhancement of clinical programs, initiatives, processes, policies,
workflows, and projects. Youd be a good fit if: - You have an NP or
PA with licensure in good standing in Connecticut - AANC or AANP
certification for NPs - Connecticut Controlled Substance
Registration - DEA Controlled Substances Registration - Certified
in Basic Life Support for Healthcare Providers - You have
experience providing clinical services to individuals with
co-occurring chronic medical and behavioral health conditions, and
have an interest in serving complex, vulnerable, and disabled
populations. - Proven skills, knowledge base, and judgment
necessary for independent clinical decision-making. - You are an
organized, efficient, independent self-starter and problem-solver,
a leader, a strategic thinker, and a mentor, who is excited about
the big picture of whole community health. - You are excited about
how technology can support your work and help drive the ongoing
evaluation toward new and better care. - You have experience caring
for seniors in a low-income community or in a community health
setting. - You have experience working collaboratively with an
interdisciplinary care team, and specifically working alongside
community health workers or care coordination staff. - Unrestricted
Connecticut Drivers License and vehicle for daily usage - Bilingual
and bicultural
Keywords: Avidity Exchange, New Haven , Advanced Practice Clinician (NP, PA) - Home Based, Waterbury, CT 06701, Other , New Haven, Connecticut
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