Virtual Primary Care NP for Complex Medicaid Patients

T.L. Johnson Agency LLC; Polska; Hybrid; PLN 391,000 - 548,000; Full time

Benefits offered by this job

Health Insurance

Job summary

Nurse Practitioner (NP) – Virtual Primary Care (Ohio) role with T.L. Johnson Agency LLC seeks an autonomous clinician to deliver advanced practice care virtually for Medicaid and Dual Eligible members, guiding an interdisciplinary team to improve outcomes in a home-centered, value-based model.

Responsibilities include telehealth assessments, medication management, care planning, and coordinating with PCPs, specialists, and community partners; plus leading advance care planning and ensuring

Qualifications

• Autonomy with full prescriptive authority.
• Extensive telehealth/remote patient management experience.
• Experience with medically complex adults/home-based care.
• Knowledge of value-based care, HCC coding, risk adjustment, STAR/HEDIS.
• Experience conducting advance care planning.

Responsibilities

• Deliver high-quality virtual clinical care and ongoing management for medically complex Medicaid and Dual Eligible members.
• Conduct patient assessments, medication management, care planning, and follow-up via telehealth and remote care technologies.
• Coordinate care with primary care providers, specialists, managed care organizations, and community partners.
• Lead and document advance care planning and goals-of-care conversations with patients and families.
• Ensure accurate, compliant clinical documentation supporting HCC coding, risk adjustment, and quality initiatives (STAR/HEDIS gap closure).
• Assist with hospital admission and discharge planning, ensuring smooth transitions back to the home setting.
• Contribute to the development and continuous improvement of clinical protocols, operational processes, and value-based care strategies.
• Participation in a rotating 24/7 triage and after-hours support model.

Skills

Telehealth experience

Autonomous practice

Value-based care knowledge

HCC coding knowledge

Risk adjustment understanding

Advance care planning

Education

Master's degree or higher

Job description

Nurse Practitioner (NP) – Virtual Primary Care (Ohio) role with T.L. Johnson Agency LLC seeks an autonomous clinician to deliver advanced practice care virtually for Medicaid and Dual Eligible members, guiding an interdisciplinary team to improve outcomes in a home-centered, value-based model.

Responsibilities include telehealth assessments, medication management, care planning, and coordinating with PCPs, specialists, and community partners; plus leading advance care planning and ensuring