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Description

At Healthcare in Action, we serve patients experiencing homelessness through an innovative "street medicine" approach by contracting with Medicare and Medicaid health plans as well as hospitals and health systems.

The Nurse Practitioner supports members who are experiencing or are at risk of experiencing homelessness with managing their own health by providing direct care as an independent healthcare provider and through coordination of care with a partner homeless services agency. Provide clinical leadership in implementing, training, monitoring, and improving Quality Hierarchical Chronic Condition initiatives. Assist in motivating behavioral changes in patients to improve health outcomes in members through education, peer support, and the relaying of shared experiences. Care is delivered directly on the street, encampment, or shelter.

This position requires the use of personal vehicles going to encampments in North LA County likeAltadena, Glendale, West Covina, El Monte and below the mountains, as well as the foothills along the outskirts to the San Bernardino County line. Must be able to perform field phlebotomy and perform minor procedures. Must be able to walk distances and potentially hike to reach encampments as well.

Responsibilities include:

Conduct physical exams and assessments including diagnostic exams; take medical histories; diagnose and document patient's health conditions; conduct wellness exams, administer vaccinations and draw blood for lab tests (if necessary). Produce care plan for patients.

Perform Chronic Care Assessments for patients.

  • Interpret and evaluate diagnostic tests to identify and assess individuals' clinical problems and health care needs.
  • Thoroughly document all chronic health conditions and consider appropriate follow up with SCAN's local provider network.
  • Organize and complete Chronic Care Assessments and chart audits for patients.

Organize and complete an individualized Care Plan for each patient.

  • Develop care plans in collaboration with patients, peer nav, and primary care physicians. Educate and advise on medical issues as needed. Consult with physicians and Medical Director as needed. Ensure Primary Care Physicians are aware of patient's health conditions and progress.
  • Provide health education to patients. Work with patients in the prevention of illness, promotion of health, and management of patient's adjustment to chronic health problems.
  • Provide referrals both internally and externally to appropriate medical resources.

Engage with providers and patients to create a trusting environment. Maintain a safe, efficient, and pleasant environment conducive to optimum patient wellbeing, in conformance with recognized standards. Function in a collaborative relationship with physicians and other health care professionals in the clinical management of patients. Maintain a good working relationship with other personnel, medical staff, and administration.

Follow company policies and procedures:

  • For the proper handling of lab specimens and biohazardous waste.
  • Document patient visit/interaction accurately and timely.
  • Report suspicious, unethical, or illegal conduct and cooperate with approved investigations and inspections.
  • Develop an understanding of Health Plan's encounter data submission process and CMS requirements. Participate in the grievance, audit and continuing education, quality assurance, and quality improvement programs. Serve as an on-going resource to providers and case management teams. Serve on and participate in appropriate clinical committees, as assigned.

Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

      • Monitor, train, and coach patients on how to live with chronic conditions to ensure health goals are met.
      • Collaborate with SCAN, Healthcare in Action team, and Quality Improvement team to achieve corporate goals. Practice medicine within the scope of a California Nurse Practitioner license

        Provide clinical Leadership of teams, consisting of social workers and peer navigators and function as a liaison to the overseeing physician and psychiatrist.

Function as an independent healthcare provider, as part of the care team, with an advanced degree of knowledge, skill and expertise in history taking, physical exam, treatment, and clinical care management of patients.

      • Contributes to team effort by accomplishing related results as needed.

      • Actively supports the achievement of Healthcare in Action's Vision and Goals.

      • Ability to drive the equipped van as needed
      • Other duties as assigned.

Qualifications and experience:

  • Graduate degree (Master of Science in Nursing or Doctor of Nursing Practice) from an accredited nursing school required.
  • Current California Nurse Practitioner license in good standing.

  • NPI

  • DEA license in good standing

  • Current First Aid/CPR/AED certification.

  • 2+ years of experience working in a medical office, hospital, population health required.

  • Demonstrated experience providing direct patient care in the field, required.
  • Experience in the military or international relief providing patient care in outdoor environments strongly preferred.
  • Experience with substance abuse and mental health highly desired.
  • Familiarity with insurance switches and navigating MediCAL.
  • Understanding of ICD-10 Coding preferred.

  • Excellent assessment skills required.

  • Ability to problem-solve and to prioritize changing patient conditions required.

  • Knowledge of efficient interviewing practices and techniques used to gather information.

  • Strong interpersonal skills with the ability to build relationships with providers and patients.

  • Ability to work on a team and maintain good working relationships with staff and patients required.

  • Excellent verbal, written communication and listening skills both in-person and on the phone required.

  • Excellent customer service skills required.

  • Ability to be culturally sensitive and work with a diverse patient population.

  • Ability to maintain quality, safety and /or infection control standards.

  • Knowledge of and/or ability to learn and use computer-based applications such as MS Office and electronic medical record systems.

  • Knowledge of medical records and appropriate documentation requirements.

  • Ability to maintain patient confidentiality required. Knowledge of HIPAA requirements.

  • Ability to remain calm and be resourceful in emergency situations required. Ability to maintain a professional demeanor at all times.

  • Ability to climb, stoop, kneel and crouch required. Ability to bend, reach, lift, pull, push and/o.

Read the full job description and apply online on the recuiter's web-site

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