Advanced Practice Provider - Pittsburgh, PA

Company: Endorsed

Job Description

JOB SUMMARY This is a full-time community-based position requiring frequent travel within the assigned territory in Pittsburgh, PA. A significant portion of this role involves conducting comprehensive health risk assessments directly with members in their homes. This role is integral to the organization's comprehensive care delivery system. The incumbent delivers high-quality, patient-centered care through in-home, virtual, and telephonic comprehensive clinical assessments for members with chronic health conditions. This autonomous position provides holistic, community-based care, especially for geriatric and palliative populations. The role proactively manages symptoms, guides advance care planning, and supports members with chronic or life-limiting illnesses to ensure optimal quality of life and health outcomes. The role involves accurately identifying and documenting all active chronic medical conditions essential for risk adjustment. ESSENTIAL RESPONSIBILITIES Comprehensive Clinical Assessments: Conduct comprehensive in-home, video, and telephonic clinical assessments, including detailed histories, physical examinations, and identification of all active diagnoses, symptoms, functional status, and social determinants of health. Diagnostic Interpretation & Treatment Planning: Order and interpret laboratory, radiological, and other diagnostic studies, then make medical diagnoses and institute appropriate therapy within applicable scope and standards of practice. Palliative Care & Symptom Management: Manage medications and treatments related to palliative care, alleviating pain and other distressing symptoms related to life-limiting illnesses. Patient & Family Guidance: Provide emotional and psychological support, and educate patients and families about illness progression, treatment options, and aligning to goals of care. Advance Care Planning: Facilitate advance care planning conversations and end-of-life discussions. Collaborative Care Coordination: Collaborate and coordinate care with other providers active on the patient's care team and participate in interdisciplinary team meetings to review and update patient care plans. Emergency Intervention: Institute emergency measures or appropriate stabilization for acute patient situations. EMR & Risk Adjustment Documentation: Utilize electronic medical record (EMR) systems for thorough and compliant clinical documentation, ensuring timely and accurate record of pertinent information to support comprehensive medical coding and risk adjustment methodologies. Reporting & Communication: Identify and inform the attending physician of record of all significant changes to the patient's ongoing condition in a timely manner. Professional Development & Compliance: Maintain mandatory professional continuing education and uphold professional practice consistent with organizational statements and medical staff compliance. Other duties as assigned or requested. EDUCATION Required Graduate from an accredited PA program OR Graduate from a Nursing Approved Master’s or Post Master’s program Substitutions None Preferred Board certification or clinical experience in a relevant specialty (e.g., Family Medicine, Internal Medicine, Geriatrics, Hospice or Palliative Care). EXPERIENCE Required 3 years of clinical experience as an NP or PA, preferably in primary care, geriatrics, palliative or hospice care, chronic disease management, home health, or a similar community-based setting. Preferred Previous experience conducting in-home assessments or house calls. Knowledge of CMS regulations and guidelines. Experience in population health management. LICENSES or CERTIFICATIONS Required CPR Certification Current Physician Assistant License OR Current State of PA RN licensure or Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) + CRNP license and Prescriptive Authority in the State of PA. Valid driver's license and reliable transportation with appropriate insurance coverage to travel to patient homes across designated service areas. Preferred DEA controlled substances license SKILLS Patient & Family Engagement: Exceptional communication, motivational interviewing and empathy skills for patient-centered care, sensitive health discussions, and effective education for diverse patient populations. Clinical Acumen & Care Planning: Expertise in critical clinical assessment and the ability to identify and address patient care gaps, opportunities for health improvement and formulate care plans including advance care planning. Interpersonal & Team Collaboration: Exceptional interpersonal and communication skills to build rapport and effectively collaborate with internal and external care teams. Autonomous Work & Caseload Management: Demonstrated ability to work autonomously and manage an effective caseload in a community-based or home care setting. Organizational & Time Management: Excellent organizational and time management skills to efficiently conduct multiple visits daily and complete documentation. Problem-Solving & Adaptability: Strong problem-solving skills and the ability to adapt to unexpected situations in the field. Technological Fluency: Proficient with EMR systems, portable diagnostic equipment, mobile technology, and standard computer applications including Microsoft Office products. Continuous Learning: Commitment to continuous learning and professional development, particularly in palliative care, geriatrics, risk adjustment, and clinical guidelines. Risk Adjustment & Documentation Acumen: Strong knowledge of risk adjustment methodologies and coding principles, coupled with the ability to ensure documentation integrity for compliant medical coding. High-Performing Team Integration: Ability to work effectively in a flexible, high-performing team environment. Language (Other than English): None Travel Requirement: 50% - 75% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Never Exposure to Blood, body fluids or tissue Occasionally Exposure to needles or sharps Occasionally Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $102,700.00 Pay Range Maximum: $164,600.00 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.