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In-Home Assessment Nurse Practitioner, Chula Vista, CA


Organization: Community Health Group
Category: Nurse Practitioner
Location: Chula Vista, CA
Date Job Posted: July 1, 2021
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In-Home Assessment Nurse Practitioner

Description

Community Health Group is a locally based non-profit health plan that ensures access to high quality, culturally sensitive health care for underserved communities throughout San Diego County. We treat our 300-member, multi-lingual staff like family, encouraging an atmosphere of collaborative teamwork, continuous learning, personal growth, and promotion from within. Recognized as one of the Top Workplaces in San Diego, CHG offers its employees such benefits as tuition reimbursement, a meditation room and yoga classes, a monthly Breakfast With The CEO, and memorable events throughout the year.

We know that by serving our employees well, they, in turn, will better serve our nearly 300,000+ membership. We have been recognized consistently for the excellence and sensitivity of our customer service by members, physicians, vendors, and a full range of health care providers. We are accredited by the National Committee for Quality Assurance and proud of our continuing company-wide Quality Initiatives.

We are currently recruiting for:

TITLE: In-Home Assessment Nurse Practitioner

EEO1: Professional

POSITION SUMMARY

The In-Home Assessment Nurse Practitioner ensures the company maintains high standards of patient outcomes and compliance with applicable regulatory requirements, by performing comprehensive in-home assessments for members by reviewing all their needs including: medical, social/psychological, financial, caregiver support and environmental safety. Assist in resolution of member complaints and/or grievances.

COMPLIANCE WITH REGULATIONS

Works closely with all departments necessary to ensure that the processes, programs and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal.

RESPONSIBILITIES

Conduct comprehensive IHAs that include, but are not limited to:

  • Review of member history.
  • Document treatment plan for each identified risk adjusted code to support the diagnoses. All documentation must be legible.
  • Document recommendations for additional screening tests to identify and/or support suspected, but not proven, risk-adjusted diagnoses.
  • Assess need for home adaptation equipment.
  • Assess need for transportation to and from other health care providers.
  • Identify responsible party (decision maker) for Member or advocates, or any active family support/assistance. Document support contact information, if available.
  • Review and document Member medications, date(s) of prescription(s) and prescriber(s); note expired drugs.
  • Document all Member past and present medical conditions by ICD-10 code; collaborate with CHG claims coders.
  • Forward IHA record and superbill to CHG within three (3) Working Days of IHA.
  • Collaborate and regularly communicate with CHG Chief Operating Officer as requested.
  • Identify metrics and key performance indicators to be reported to CHG on a regular basis as mutually agreed upon by the parties.
  • Cooperate with CHG Chief Operating Officer to resolve Member complaints and grievances.
  • Notify CHG of broken appointments.
  • Meet with CHG, at CHG’s request, to review cases and discuss opportunities for operational improvements.
  • Assist in resolution of member complaints and/or grievances.

Qualifications

EDUCATION

  • Current, unencumbered NP license in California

EXPERIENCE/SKILLS

  • One year, post graduate hands-on clinical experience.
  • Bilingual, English/Spanish preferred.
  • Experience with and sensitivity to cultural background and linguistic needs of membership.
  • Familiarity and respect for special social needs of Medi-Cal and Medicare populations.
  • Familiarity with Medi-Cal and Medicare program eligibility and community based organizations.
  • Bilingual English/Spanish required.
  • Excellent communication and interpersonal skills.

PHYSICAL REQUIREMENTS

  • Will be required to conduct home and on-site visits.
  • Constant driving within San Diego County.
  • Must be available to work evenings, weekends, and some holidays.
  • Will be required attend meetings outside of facility or normal business hours.
  • Valid driver’s license, working/reliable vehicle, and automobile insurance.

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