Nurse Practitioner - Home Visits - Per Diem id-15423

January 21, 2025

Overview

ComplexCare Solutions (CCS) specializes in helping those in need by delivering high value in-home and virtual assessments for health plans nationwide. We pride ourselves on our member engagement aimed towards evaluating current health status, gaps in care, potential health risks and care management opportunities with a focus on driving better clinical outcomes. Our visits give Providers the opportunity to spend a full hour with these members which allows them to capture a comprehensive picture of that individual's personal needs and what is required to keep them in the home and out of the hospital.

CCS is calling on Nurse Practitioners that are passionate about helping their local communities. We care dearly about those we serve and we need your help to make a difference in the lives of our members.

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Responsibilities

Knowledge of CMS Regulations and NCQA HEDIS Guidelines;
Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD-9, ICD-10 and CPT-4 coding practices;
Complete comprehensive, accurate and thorough review of the assigned member population, including timely completion and submission of all required encounter documentation (paper or electronic);
Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Inovalon policy, and client requirements;
Support the physician/patient relationship and ensure timely and adequate communication, documentation of assessment findings, recommendations, need for additional services, emergency services required if necessary and need for follow up and timelines for follow up to primary care provider (PCP) and health plan as required;
Make general recommendations to members intended to improve members' knowledge of their chronic condition(s), such as information concerning recommended testing;
Address and close identified gaps in care (disease-specific or preventive);
Recognize emergent or urgent situations requiring escalation and take appropriate action as specified in Inovalon policies, and as determined by reasonable professional judgment and ethical professional practice standards; and
Perform, document and communicate results of Point of Care (POC) Testing.
Maintain compliance with Inovalon's policies, procedures and mission statement;
Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position;
Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company;
Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function;
We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.
Other duties as assigned

Qualifications

Active un-encumbered license to practice nursing;
Nurse Practitioner Certification from either the ANCC or AANP; in Family, Adult, Gerontology or Emergency Medicine.
Board Certified through the AANP or ANCC
Maintains current CPR certification
Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing: Hepatitis B, Influenza, MMR: Measles, Mumps and Rubella, Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap), Varicella, Tuberculosis
Home Health exp a plus
Must be able to effectively communicate with elderly and chronically ill patients and families;
Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial;
Ability to multitask;
Excellent customer service skills;
Bi-lingual or multi-lingual a plus.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

DISCLAIMER

Other Jobs You May Be Interested In

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

5. HOW DO YOU PROCESS INFORMATION?

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

8. HOW TO PRIORITIZE WORK?

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

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