CareSource

Member-first health plan: Marketplace, Medicare, Medicaid

Nurse Practitioner / Physician Assistant - Care Delivery Advanced Practice Clinician

Advanced Practice ProvidersConfirmed live in the last 24 hours

Full-timeSpringfield, MA, USA

About the Job

Requirements

A master's degree in Nursing or a degree in Physician Assistant Studies is required; a doctoral degree in Nursing Practice is preferred.
Completion of an accredited program and board certification as a Nurse Practitioner or Physician Assistant is required.
At least two years of experience as an NP or PA caring for patients with complex medical, behavioral health, and social needs is required, with community-setting experience preferred; alternatively, one year of NP or PA experience in primary care or care management plus three years of experience as a Registered Nurse or EMT-P in a high-touch clinical environment or home care is required, or five years of Registered Nurse or EMT-P experience in a high-touch clinical environment or home care is required.
Experience with an electronic medical record is strongly preferred; experience with eCW is a plus.
Experience working with a managed-care population is preferred.
Experience with Medicaid or Medicare programming and insurance products such as ACO, MCO, PACE, or SCO is preferred.
Demonstrated clinical decision-making skills, knowledge, and judgment are required.
Organizational, time-management, and problem-solving skills are required.
Ability to function effectively as part of a multidisciplinary team is required.
Effective written, verbal, and electronic communication skills are required.
Teaching skills, mediation, and conflict-resolution skills are required.
Ability to advocate for a complex patient population in a culturally competent manner is required.
Ability to learn and use telehealth technologies, including video and chat, for clinical care and care-management services is required.
Ability to use and navigate multiple electronic health record platforms is required.
A current unrestricted Massachusetts physician assistant license or an unrestricted advanced-practice RN license, including a valid Massachusetts RN license in good standing, is required.
A current Massachusetts Controlled Substances License and a current DEA Controlled Substances License are required.
Current CPR or Basic Life Support certification is required.
A valid driver's license, vehicle, and verifiable insurance are required; employment is conditional on an acceptable driver's-license record check.
Annual influenza vaccination is required for designated positions during influenza season; employees hired during that season have 30 days from hire to complete it.
Must reside in the assigned territory, with exceptions potentially considered based on business need.
Ability to travel routinely, potentially more than 50% of the time, is required.
Ability to work flexible hours, including possible evenings or weekends, is required.
Ability to frequently lift or move up to 10 pounds and occasionally more than 100 pounds is required.
Employment is conditional on a successful criminal background check.

Responsibilities

Provide longitudinal primary care and wrap-around care, including routine and urgent care, to an attributed patient panel in clinic, through home visits, and using telehealth technologies such as video and chat.
Facilitate and deliver preventive care according to guidelines deemed appropriate by Clinical Leadership.
Conduct annual patient visits, take detailed histories, perform physical examinations, document appropriate diagnoses, develop comprehensive medical care plans, and ensure capture of high-risk diagnoses under CMS guidelines.
Perform episodic urgent medical visits to provide timely and appropriate care and help avoid emergency room visits or hospitalization.
Prescribe medically necessary and appropriate medications and treatments, consulting with a physician when needed, including medication-assisted treatment when clinically appropriate.
Conduct post-discharge visits within two weeks of discharge from an acute-care or skilled-nursing facility to help reduce admissions and readmissions; perform detailed medication reconciliation and adjust medications as indicated.
Collaborate with inpatient or post-acute care teams and patients on discharge planning, in person at facilities, by telephone, or virtually.
Use emergency medical or psychiatric services as indicated to mitigate emergency-service use and inpatient admissions.
Document visits with clear, comprehensive, and concise charting to identify, document, and execute a patient-centered plan of care.
Serve as a clinical mentor for medical care.
Work proactively and collaboratively with patients’ primary care providers and other external providers to ensure delivery of a cohesive medical treatment plan.
Identify and lead ad hoc case reviews with internal and external care teams as needed.
Participate in committees and workgroups that promote clinical excellence and advance organizational mission and business objectives.
Assist leadership with development, refinement, and enhancement of clinical programs, initiatives, processes, policies, workflows, and projects.
Provide clinical coverage for colleagues as needed.
Perform other job-related duties as requested.

Desired Qualifications

Bilingual or multilingual ability is preferred.

Job Summary:

The Care Delivery Advanced Practice Clinician (APC) provides comprehensive primary care and clinical care coordination to a panel of patients, including individuals with significant medical, behavioral, and social complexities that require intensive care coordination and care delivery. This role provides ongoing chronic disease consultation and management, promotes preventative care through education and identification of age-appropriate preventative screens, provides urgent care, and acts as a liaison with other health professionals as needed.

Essential Functions

Performs longitudinal primary care and wrap-around care including routine, and urgent care for an attributed patient panel in clinic, through home visits, and utilizing telehealth technologies (video, chat, etc.).
Facilitates and delivers preventative care to patients according to guidelines deemed appropriate by Clinical Leadership.
Conduct Annual Visits with patients, taking a detailed history, performing a physical examination, and documenting appropriate diagnoses to develop a comprehensive medical care plan and ensure capture of high-risk diagnoses under CMS guidelines.
Performs episodic urgent medical visits to ensure that patients are given timely and appropriate medical care to avoid emergency room visits or hospitalization.
Prescribes medically necessary and appropriate medications and treatments, in consultation with the physician where needed, including prescribing medication assisted treatment (MAT) for some conditions when clinically appropriate.
Performs post discharge visits on patients within two weeks of discharge from either an acute care facility or a skilled nursing facility with the goal of decreasing admissions and re-admission; performs detailed medication reconciliation and adjust medications as indicated.
Collaborates with inpatient or post-acute care team and patient to optimize discharge planning in collaboration with Transitions of Care (done in-person at facility, telephonically, or virtually).
Leverage emergency medical or psychiatric services as indicated to mitigate Emergency Services and inpatient admissions.
Documents all visits with focus on clear, comprehensive, and concise charting to identify, document, and execute a patient-centric plan of care.
Serve as a clinical mentor for medical care.
Proactively and collaboratively work with patients’ Primary Care Provider (PCP) and other external providers to ensure a cohesive medical treatment plan is delivered.
Identify and lead ad-hoc case reviews with internal/external care team as needed.
Participates in committees and workgroups that promote clinical excellence and help to advance the organization's mission and business objectives.
Assists leadership with the development, refinement and enhancement of clinical programs, initiatives, processes, policies, workflows, and projects
Provide clinical coverage for colleagues as needed.
Perform any other job related duties as requested.

Education and Experience

Master's degree in Nursing or a degree in Physician Assistant Studies required
Doctoral degree of Nursing Practice preferred
Completion of accredited program and board certification as a Nurse Practitioner or Physician Assistant required
Two (2) years of experience as NP or PA caring for patients with complex medical, behavioral health, and social needs; preferred experience in community setting required or
One (1) year of experience as NP or PA in primary care or care management and
Three (3) years experience as Registered Nurse or EMT-P in a high touch clinical environment or home care required or
Five (5) years experience as Registered Nurse or EMT-P in a high touch clinical environment or home care required
Experience with electronic medical record (eCW a plus) strongly preferred
Experience working with managed care population preferred
Experience with Medicaid or Medicare programming and insurance products (i.e. ACO, MCO, PACE, or SCO) preferred

Competencies, Knowledge and Skills

Proven skills, knowledge base, and judgment necessary for independent clinical decision making
Excellent organizational, time management and problem-solving skills
Ability to function effectively as part of a multi‐disciplinary team
Strong and effective communication skills, written, verbal, and via electronic modalities
Effective teaching skills
Mediation and conflict resolution skills
Ability to advocate for a complex patient population in a culturally competent manner
Bilingual or multilingual preferred
Ability to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services
Demonstrated ability to utilize and toggle through multiple EHR platforms

Licensure and Certification

Current unrestricted license to practice as a physician assistant from the Board of Registration of Physician Assistants in Massachusetts required or
Current unrestricted license to practice as an advanced practice RN from the Board of Registration in Medicine, which includes valid Massachusetts RN licensure in good standing required
Current Massachusetts Controlled Substances License required
Current DEA Controlled Substances License required
Current CPR or Basic Life Support (BLS) Certification required
Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions

This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members
Must frequently lift and/or move up to 10 pounds and occasionally lift and/or move more than 100 pounds
Over 50% (Mobile) Routine travel required

Background Check

Employment in this position is conditional pending successful clearance of a criminal background check. If the criminal background results are unacceptable, the offer will be withdrawn or, if employee has started in position, employment in position will be terminated.

Compensation Range:

$99,600.00 - $159,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-PB1Brand=Commonwealth Care Alliance

About the Company

CareSource

Member-first health plan: Marketplace, Medicare, Medicaid

CareSource provides health coverage to more than 2 million members, offering Marketplace plans as well as Medicare and Medicaid products. Its core service is delivering health insurance and related care to individuals and communities through a member-first approach, aiming to improve health and well-being over time. The company operates with a focus on affordable, accessible coverage and care coordination across states, guided by its mission to place people over profits rather than simply selling plans. Key differentiators include a long history (30+ years), a national footprint with 4,500+ employees, and an emphasis on serving members’ needs and languages while promoting equal opportunity employment. The overarching goal is to help members live healthier lives by providing comprehensive coverage and support.

Company size: 1,001-5,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Dayton, OH
Founded: 1989

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