Full-Time

Nurse Practitioner

Clinical Operations, Sphere Senior

Di Rezze Family Office

Di Rezze Family Office

No salary listed

Aventura, FL, USA

Hybrid

In-home travel required; field-based role with remote clinical support.

Master's, PhD

Category
Medical, Clinical & Veterinary (1)
Requirements
  • Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)
  • Active, unrestricted NP license in the state(s) of practice
  • National certification: ANCC (AGPCNP-BC preferred, FNP-BC accepted) or AANP (FNP-C)
  • Active DEA registration (or ability to obtain prior to start)
  • BLS certification; ACLS preferred
  • 2+ years of NP experience in geriatrics, primary care, home-based care, SNF/LTC, or complex care management
  • Demonstrated comfort with telehealth, digital health tools, and AI-assisted clinical workflows
  • Strong interpersonal skills — clear communicator across varying health literacy levels
  • Valid driver's license and reliable transportation (in-home travel required)
Responsibilities
  • Conduct comprehensive in-home assessments, physical exams, acute visits, and longitudinal follow-ups for a complex geriatric patient panel
  • Diagnose and manage multi-morbidity with clinical precision: heart failure, COPD, diabetes, dementia, CKD, frailty syndromes, polypharmacy, and fall risk
  • Develop individualized, patient-centered care plans in collaboration with patients, caregivers, and the interdisciplinary care team and actively monitor and adjust them over time
  • Prescribe medications and therapies in accordance with state scope-of-practice regulations and evidence-based protocols
  • Conduct advance care planning and goals-of-care conversations with sensitivity and clinical skill
  • Provide serious illness and palliative care support, including symptom management and family guidance
  • Own post-hospitalization and SNF discharge follow-up to prevent avoidable readmissions, bridge visits, medication reconciliation, care plan updates
  • Collaborate with care coordinators on real-time ED diversion and transition-of-care workflows
  • Identify and escalate high-risk patients proactively using SphereOS risk stratification tools before crises occur
  • Participate in risk stratification reviews, interdisciplinary care team huddles, and care committee meetings
  • Collaborate with care coordinators, social workers, behavioral health staff, and the Medical Director on complex cases
  • Contribute to quality improvement initiatives, readmission reduction, HEDIS/Stars gap closure, advance care planning rates
  • Document all clinical encounters accurately and promptly within SphereOS/EHR — complete, billable, compliant
  • Respond to urgent clinical needs during shift hours in coordination with on-call protocols
  • Participate in structured after-hours on-call rotation (low-burden, shared with Medical Director and APP team)
Desired Qualifications
  • Experience in home-based primary care (HBPC), PACE, or value-based care programs
  • Palliative care training or certification (ACHPN or equivalent)
  • Familiarity with risk stratification tools: HCC coding, LACE index, CMS-HCC models
  • Experience with ACO, MSSP, or Medicare Advantage quality programs
  • Bilingual — Spanish, Mandarin, Cantonese, Vietnamese, or other languages spoken by patient communities
  • Comfort working independently in field-based settings with minimal on-site supervision
Di Rezze Family Office

Di Rezze Family Office

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