The WellBe care model is a Physician Led Advanced Practice geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. WellBe's physician/Advanced Practicing Provider (APP) led geriatric care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.
Our APPs are critical to our team that provides compassionate care to the frailest elderly who have chronic and acute illnesses or injuries living in their homes. They deliver primary, urgent and acute medical care to a wide variety of patients. The Floater Nurse Practitioner will be accountable for caring for patients, maintaining accurate and current patient records, and scheduling initial, urgent, and follow-up appointments to patients as required across various geographies based on market need. This role helps to assure ongoing clinical coverage for consistent patient care delivery. The successful candidate will work as a team with our physicians, advanced practicing providers, social workers, paramedics, and care team coordinators to assist in delivering concierge care to every patient. We offer a positive, upbeat work environment where all medical personnel work together for the good of the patient across the community and market.
SKILLS & COMPETENCIES
Practices the WellBe mission: To help our patients lead healthier, meaningful lives by delivering the most Complete Care.
Partners with other clinicians in the “Care Community managing the health and wellbeing of patients living in their homes.
Covers territories in geographic assignment based on tiered prioritization for the role.
Responsible engaging attributed patient into WellBe program
Provides primary care to patients in the home
Facilitates staff, patient, and family decision making by providing educational resources.
Performs initial patient screenings/physical examinations creates appropriate assessment/plan
Addresses urgent care needs of the patients as needed
Collaborates with community team to complete care assessment
Orders, interprets, and analyzes diagnostic tests and determine the need for follow-up appointments and further treatment options
Prescribes and manage medications and treatments as appropriate, including but not limited to psychopharmacological agents
Updates patient records and check records for accuracy at each patient appointment
Delivers quality care while maintaining all company metrics pertaining to appropriate documentation/coding, HEDIS measures, engagement of patients, and managing medical expense.
Serves as a resource for patients in delivering ongoing care information, counseling and guidance for any patients with critical conditions.
Refer to internal/external resources as appropriate such as WellBe behavioral health protocols
Collaborates with the interdisciplinary team and participate in regularly scheduled team meetings
Maintain required licensure and certification
Deliver palliative care, and when needed, end of life care to patients and families
Facilitates family meetings with WellBe community team, to help with complicated family dynamics and goals of care
Other tasks needed to accomplish team’s objectives/goals
Educational/ Experience Requirements:
Minimum Master’s Degree in Nursing
Valid nurse practitioner license or the ability to obtain on in the state of WellBe operations
Current board certification in your field (ANP, GNP, FNP, etc)
BLS certified and an NPI# as an NP
3-5 years nurse practitioner experience
Have a valid driver’s license, car insurance, have access to a car and willingness to drive to patient homes/patient location, as well as an active auto insurance policy
Required Skills and Abilities:
Role model in courageous teamwork, integrity, ethics, and productivity
Experience in diagnose and treat chronic and urgent medical/psychological conditions of older adults
Experience in end of life, geriatrics, internal medicine, palliative care
Excellent verbal, written, presentation, and interpersonal communication skills
Confident speaker to internal and external groups
Strong computer skills, including Word, Excel, and Powerpoint
Must be familiar with EHR medical documentation
Home care experience preferrered
Supervisory Responsibility: This position will not have supervisory responsibility.
Travel requirements: Travel may be required up to 100% locally, across market, on business needs. Distance of travel is based on both the calculated geographical need and the patient care assignment need and can vary depending on these variables.
Work Conditions: Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs. Ability to stand for extended periods.
Ability to drive to patient locations (ie. home, hospital, SNF, etc). Fine motor skills/Visual acuity
The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.
Job ID: 2023-2944
External Company Name: Wellbe Senior Medical