What You'll Do
As part of Strive’s interdisciplinary clinical care team, the NP Lead will utilize their advanced education, skills, and judgment to deliver advanced nursing care for CKD and ESRD patients. The NP Lead will be responsible for managing patient care by collaborating with the Strive interdisciplinary team of RN Care Managers, social workers, care coordinators, pharmacists, dietitians, and physicians to provide best in class patient care. The Strive NP Lead will be an advocate, navigator, trusted clinician, and safety net for the patient while delivering exceptional clinical care, building empathy and trust with patients, and delivering a world class patient experience. In addition to co-managing a panel of patients, the NP Lead will also supervise the local team of Nurse Practitioners while acting as the clinical subject matter expert and resource for patients, their families, the local care team, and other healthcare professionals.
The Day to Day
- Understands value-based care and applies principles to practice.
- Accountable for patient outcomes and KPIs for a panel of CKD and ESRD patients.
- Assess patient needs, deliver advanced quality nursing care, and achieve optimal patient outcomes for patients with chronic kidney disease and ESRD.
- Obtains patient history, performs appropriate physical exam, orders and interprets diagnostic tests and lab values to identify and assess patient’s health care needs.
- On an ongoing basis, monitors and documents patient condition, response to the care plan and significant incidents.
- Must meet expectations of Strive’s documentation policy.
- Alongside with other members of the interdisciplinary team, will assure that a patient’s need for immediate and/or emergent care is handled promptly and appropriately.
- Willingness to drive prevention at every opportunity to slow progression, decrease exacerbations, and minimize complications, while keeping in mind what the patient wants for their life.
- Accountable across the continuum of disease process, healthcare systems, and patient’s lives.
- Assesses the longitudinal needs of patients and individualizes them in the patient’s plan of care.
- Collaborates well with all levels of the clinical team and is able to align and influence the care needs of a patient. Serves as a liaison with dialysis facilities, PCPs, and nephrologists, providing care plan updates to help streamline the transitions in care.
- Remains up-to-date and current on advances and trends in renal care treatment, guidelines, policies and procedures.
- Follows evidence-based medicine and incorporates best practices into patient care.
- Provides patients home visits and willing to be on call.
- Follows established best practices for kidney care, including:
- Patient Intake and Assessment
- CKD clinical care includes management of CKD progression and co-morbidities and support of transitions to renal replacement therapy or conservative care
- ESRD clinical care and co-morbidity management
- Preventative care
- Patient engagement
- Close monitoring of high-risk patients
- Participation in shared decision making and Advanced Care Planning discussions
- Transplant Support – pre and post
- Collaboration with inpatient providers and Post Discharge Support
- ER Diversion
- End of Life Support
- Serves patients in person and in multiple care settings (e.g., patients' home, clinics) in addition to virtual visits.
- Provides patient visits via home and telehealth.
- Meet in person with internal and/or external stakeholders to facilitate team and business priorities/opportunities.
- Serves as a liaison with dialysis facilities, PCPs, and nephrologists, providing care plan updates to help streamline the transitions in care.
- Participates in Strive’s on-call program.
- Manages NP care team-- PTO approval, Time and Attendance approval and tracking, CME tracking, team scheduling and approval, performance reviews, chart audits
- Manages clinical oversight of care team
Minimum Qualifications
- Completion of Master’s or Doctorate level degree in Nursing
- Minimum of three (3) years' experience as a Nurse Practitioner
- Current active licensure in any state within the US required
- National Board Certification
- Current Drug Enforcement Administration (DEA) license required or eligible to obtain within 90 days of hire
- Current Basic Life Support (BLS) certification required
- Experience as a Family Nurse Practitioner (NP), Primary Care Nurse Practitioner (NP) or experience in internal medicine, cardiology, Nephrology or Case Management
- Basic computer skills and experience with EHR required
- Must be able to travel by public transportation (eg. Trains, Airplanes, Subways, Ferry, etc.)
- Must have the ability to travel to member’s visit location
- 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
Preferred Qualifications
- Wound Care certification is a plus
- Demonstrated proficiency in clinical assessment, diagnosis, planning, implementation, documentation, and evaluation of complex chronic patients
- Excellent communicator, team builder, and results oriented
- Demonstrated knowledge and understanding of data and managing to clinical, financial, and patient satisfaction outcomes
- Excels at developing and fostering strong patient and family relationships that center on engagement, trust, honesty, empathy, follow-through and doing what’s best for the patient
- Preferred experience in internal medicine, nephrology, cardiology, acute care, or ICU care
- Previous managerial experience
Physical/Environmental Demands
- Ability to reach overhead and side to side
- Lifting overheard and carrying of 10lbs routinely, 20 lbs sporadically
- Ability to sit, stand and kneel as needed to perform physical assessment
- Ability to grasp and hold medical instruments as needed to perform physical assessment
- Ability to navigate stairs and a variety of patients dwelling conditions and configurations
Annual Salary Range: $109,000.00-$136,000.00