Job Description

Company: MDX Hawai'i, Inc. Location: Remote - HI Job Title: Nurse Practitioner Job Description: The Nurse Practitioner (NP)/Advanced Practice Nurse (APRN) is a licensed independent practitioner who provides clinical assessment and care to assigned patients including assessments of health plan members in their homes, and in clinics and facilities. The responsibilities include: adult/geriatric assessment, medical history, physical exam, medication reconciliation, risk assessment, diagnosis, and health education of member/family on various aspects of their health care, disease process and expectations. Additionally, patient education, communication to the PCP, follow-up facilitated with the PCP, and case management referrals may also be part of any assessment. Clear documentation, according to CMS and federal and state guidelines and protocols, is required. Other clinical care services may be required within the NP/APRN scope of practice, including but not limited to annual health assessment evaluations, post hospital follow up, post hospital or SNF medication reconciliation, etc. Nurse Practitioners are expected to achieve MDX Hawai’i standards for quality, customer service, productivity and teamwork through participation in Quality programs, provider education sessions, clinical meetings and other meetings as required. TYPICAL WORKING CONDITIONS: Field based position; Incumbent will work in the office setting, provider office settings and other locations where demonstrations, evaluations and/or training sessions are performed. Requires travel via own automobile throughout O‘ahu. Required day and/or overnight travel to Neighbor Islands may be warranted at times. Requirements as set forth in the specific contract for the site may include working flexible hours including evenings, nights and weekends. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Effectively demonstrate the ability to identify, accurately diagnose, assess / reassess and document on primary care chronic disease diagnoses, utilizing the CMS – HCC risk adjustment model. Recognizes the needs of clinical complex patients, conditions, characteristics and behaviors that place patients at risk.
• Order and interpret diagnostic and therapeutic tests relative to patient’s age-specific needs and to identify and assess patients’ clinical problems and health care needs, recommend appropriate follow-up and reconciles medications.
• Accurately complete AHAs and/or AWVs consistent with CMS policies and protocols.
• Identify unmet gaps in care, and provide appropriate recommendations to PCP and/or specialists in a timely manner.
• Provide timely disposition forms to PCP and/or specialists on the day of the visit. Notify PCP of record of any urgently needed follow-up as needed and assist the patient to make this follow-up as needed. Activate 911 if needed for emergencies.
• Provide instruction to patient and recommend appropriate follow up to patient in a clear manner.
• Prescribe or recommend medications or other forms of treatment such as physical therapy, inhalation therapy, or related therapeutic procedures
• Work collaboratively with various MDX Hawaii physicians in the community and their associated staff and assist in logistics and scheduling of these appointments as needed, case managers, social workers, family members, key care givers and any appropriate ancillary medical personnel as appropriate and assist in scheduling appointments as needed.
• Provide education, training and support to as needed to MDX Hawaii physicians as needed.

• Function independently to perform age-appropriate, comprehensive history and physicals called Annual Health Assessments (AHAs) or Medicare Annual Wellness Visits (AWVs) to provide appropriate preventive health measure recommendations and screenings in various settings: in the patient home, in the physician office or facility settings.

• Accurately complete summary and care management referral forms. Create a comprehensive plan of care which is individualized to the member and consistent with CMS policies and protocols. Identify unmet needs and gaps in care. Initiate appropriate referrals and outreach to PCP, specialists and health plans. Compose visit summary portion of provider letter.
• Achieve clinical performance targets. Accurately complete assessments and achieve target quality metrics.

• Monitor and perform follow-up with providers and clinics for completion of Annual Wellness Assessments and medical records, and provides education, training and support as needed to these offices.

• Participate in all mandatory compliance and other training programs, seek guidance for compliance-related concerns and adhere to all applicable laws and regulations including but not limited to, OSHA, CLIA, State Board of Nursing and Federal DEA Board of regulations.

• Assist in the development and preparation of PCP/specialist/patient education materials, guidelines and programs to better provider/patient engagement in participating to better manage disease states. Create performance improvement plans as needed.
• Maintain medical records and all PHI in accordance with State and/or Federal confidentiality/privacy laws.
• Maintain confidentiality of all company, provider, member and client information in accordance with MDX Hawai’i HIPAA established policies and procedures.
• Adhere to all MDX Hawai’i policies and procedures including safely rules.
• Follow all Department policies and procedures, including, but not limited to procedural guidelines/workflows, attendance requirements and performance requirements as communicated by management.
• Assists on special projects as assigned.

MARGINAL DUTIES AND RESPONSIBILITIES include the following, additional duties may be assigned.

• Support the Plan’s Quality Monitoring Program; participate in ongoing clinical quality improvement activities as it relates to internal and external programs and processes.
• Assist with liaison meetings between MDX Hawai‘i functional areas and with outside vendors/customers.
• Participate in liaison meetings between MDX Hawai‘i functional areas and outside vendors/customers/providers.
• Attend workshops and seminars to improve knowledge.
• Participate in provider meetings, seminars, special events, direct mail activities and other projects assigned.

QUALIFICATION REQUIREMENTS: T MENTAL, PHYSICAL AND COMMUNICATION DEMANDS:

• Proven ability to perform comprehensive, adult/geriatric physical exam
• Ability to work calmly under pressure and appropriately plan, prioritize, organize and carry out tasks and responsibilities. Ability to work unsupervised, taking responsibility for own actions.
• Is dedicated to meeting the expectations and requirements of both external and internal customers, acts with customers in mind. Is action oriented and sees challenges as opportunities.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to effectively write reports, correspondence and procedure manuals.

• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

• Good decision making and critical thinking skills. Ability to motivate people. Ability to read, analyze, and interpret complex documents. Ability to respond effectively to sensitive inquiries or complaints.
• Ability to maintain clinical dialogue with physicians and staff regarding program requirements and speak before groups effectively present information and respond to questions from providers, office staff, managers, clients and the general public.
• Essential: finger dexterity, hearing, speaking, seeing, frequent gripping of an object for prolonged periods, carrying usual amounts of 5 – 30 lbs., lifting and pushing/pulling usual amount of 5 – 30 lbs.
• Frequently required to stand; walk; sit and use hands to finger, handle, or feel. The employee is occasionally required to reach with hands and arms; stoop, kneel, crouch, or crawl and taste or smell.

• Must be able to observe "Universal Precautions" for blood-borne pathogens and body fluids

• Requires the ability to travel via automobile and airplane to meet with individual providers or groups of providers.

TRAVEL REQUIREMENTS: Travel required

• Must meet company driving standards
• Must have valid state driver license and be able to drive a car
• Must meet company's automobile liability insurance standards and provide proof of coverage
• Must be able to travel by public transportation, and airplanes
• Must be able to independently travel to assigned locations

EDUCATION AND/OR EXPERIENCE:

• Graduate of an accredited school of nursing
• Graduate of an accredited Nurse Practitioner or Advanced Practice Nurse Program
• At least three years of clinical experience as a Nurse Practitioner in an ambulatory care, occupational health, geriatric, adult or family practice or emergency department setting preferred
• Two years experience in managed care or the health care industry with focus on government programs strongly preferred.

• Current Certification in AHA or ARC Basic Life Support for medical provider is required, Advanced Cardiac Life Support may also be required based on contract scope of services

• Knowledge of workplace health and safety concepts and OSHA regulations preferred

LICENSES, CERTIFICATIONS, REGISTRATIONS:

• Current unencumbered Hawai‘i RN and APRN license.
• Appropriate certification to write prescriptions as allowed by Hawai‘i licensing for scope of practice.
• Current Certification in AHA or ARC Basic Life Support for medical provider is required, Advanced Cardiac Life Support may also be required based on contract scope of services
• Current/valid Hawai‘i Driver’s License.
• Proof of Hawai‘i No-Fault Auto Insurance.
• Clean driving record as evidenced by a recent driver’s abstract (to be provided by the employee).