Job Description

Job Description

Job Description

Salary:

This is a hybrid position that requires an in person start of care visit in the patient's home

Our Organization: 

Welcome to Arkos Health! We are a value-based healthcare company providing solutions for payors and providers by combining unique technology with in-home, virtual, and in-clinical care for patients. Backed by a robust technology platform, innovative software, and a light human touch, Arkos Health is committed to delivering advanced and accessible community-based services allowing our clients to live healthier, more independent lives. How do we do this? Arkos serves health plans and provider organizations by managing their highest-risk and highest-cost populations. Our goal is to be the most valued partner to health plans, service providers, and the community we collectively serve.

How You'll Make a Difference: 

The Medicare Nurse Practitioner (MNP) is responsible for supporting members of Arizona Medicare/Medicaid through clinical and documentation review, attestation, and guidance of the Case Management, Social Services, and Quality (HEDIS/STARS) staff at the direction of the Arizona Medical Director. The MNP will also support members through telemedicine visits as needed. The MNP demonstrates a high level of clinical expertise in working with members of all ages with acute and chronic conditions. This position is recognized as an Advanced Practice Registered Nurse and Independent Licensed Practitioner by the Arizona State Board of Nursing and will provide care within the scope of practice as outlined by applicable state law, licensing, and regulations.

Essential Duties and Responsibilities :

• Review and sign-off on all documentation in EMR completed by the Case Management, Social Services, and Quality Teams for submission to the health plan.
• Order, perform, and interpret diagnostic tests and communicate results timely with member and provider as needed.
• Demonstrate understanding and working knowledge of key elements of Case Management, Social Services, and Quality (HEDIS/STARS) teams.
• Collaborate closely with the Medical Director and EVP of Medical Affairs in quality improvement activities and contribute to ongoing development of care improvement.
• When a telehealth visit is needed to promote health and wellness, conduct thorough review of available member records in preparation for scheduled/asynchronous visit to assist in supporting capture of appropriate diagnoses, education, counseling, and care delivery. Examples of telehealth visits would include a telehealth visit to educate a member or check-in after a previous home visit.
  • Order and refer for other services based on evaluation/recommendations (e.g., DME, PT/OT/ST, specialist, etc.)
  • Telehealth visits for medication adherence measures, make recommendations and/or adjustments to medications, and prescribe as needed.
  • Demonstrate knowledge of etiologies, risk factors, pathophysiology, and presentation of acute and chronic conditions.
• Demonstrate and maintain accurate, complete, and timely documentation in electronic health record to include but not limited to:
  • Correct diagnosis code(s).
  • Correct CPTII coding.
  • Status of all acute and chronic conditions identified.
  • Plan to address all diagnosis identified at time of visit.
  • Excluding members from a HEDIS/STAR measures if applicable during a video telehealth visit.
  • Include all required documentation to close hybrid HEDIS/STAR measures administratively.
  • Update past medical history (PMH) for previously completed diagnostic studies.
• Utilize critical thinking to interpret diagnostic studies and screening evaluations and develop appropriate diagnosis and plan based on results
• Communicate and collaborate effectively with physicians, other health professionals, care delivery team, and health related agencies to promote continuity of care for member
• Manage conditions based on knowledge of the indications, contraindications, side effects, interactions and adverse reactions of relevant treatment modalities and pharmacologic agents
• Demonstrate and participate at an advanced level of nursing knowledge with interdisciplinary care team to assure safe, effective, quality member care
• Function as clinical resource in collaboration with member care team and serve as an internal resource for clinical and non-clinical staff to promote positive interactions in support of member care and outcomes

Qualifications and Skills:

• Current and valid State of Arizona RN license required.
• Board Certification from a nationally recognized certifying body for Nurse Practitioners required.
• Unrestricted prescribing and dispensing privileges with DEA licensure required.
• Ability to problem solve and prioritize dynamic patient conditions.
• Flexibility, adaptability with ability to shift work assigned based on competing needs of the organization.
• Bachelor’s degree in Nursing and Arizona Advanced Practice Nursing license required; Master’s degree in nursing preferred.
• 2 years’ experience as Advanced Practice Nurse preferred.
• Experience working with all ages of the population preferred.
• Experience and understanding of population health management preferred.
• Experience and understanding of HEDIS/STARs and HCC coding preferred.

Benefits: 

• Employer-paid Medical premiums at no cost to you
• Employer-paid Dental premiums at no cost to you
• Employer-paid Vision premiums at no cost to you
• Employer-paid Short-Term Disability premiums at no cost to you
• Employer-paid Life Insurance premiums at no cost to you
• Employer matching 401(k)
• 15 days annual combined sick/vacation and 9 days of holiday during your first year
• Your Birthday off!

Must complete our Culture Index Survey.  Take the assessment at This is not a pass/fail test and does not measure intelligence. 

Arkos Health EEO Statement: 

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. 

Arkos Health is a drug-free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check. 

Arkos Health participates in E-Verify to confirm eligibility to work in the United States. To view the details on this program, visit our career page at Careers - Arkos Health

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