Central Pre-Enrollment Provider Nurse Practitioner

Socket.dev; United States; On-site; USD 116,000 - 152,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid parental leave

Short-term disability

Long-term disability

Life insurance

Flexible spending accounts

401(k) with match

Paid time off

Company paid holidays

Job summary

Habitat Health seeks a Nurse Practitioner or Physician Assistant to join our remote Pre-Enrollment team, serving as the clinical backbone for chart reviews to determine PACE eligibility and Health & Safety considerations. You’ll work with Site Medical Directors across California sites and report to the Chief Medical Officer.

Responsibilities include thorough chart reviews, presenting cases, closing documentation gaps with Enrollment RNs, and ensuring regulatory standards are met for timely

Qualifications

• Active NP or PA license in California.
• DEA certification with furnishing authority in California.
• Minimum 3 years post-licensure experience in geriatrics/PACE-adjacent settings.
• Strong chart review proficiency for PACE eligibility and H&S determinations.
• Proficient with geriatric assessment tools (BIMS, PHQ-9, MoCA, MMSE, ADL/IADL).
• Solid ILOC documentation skills meeting California standards.
• Experience with Epic EHR and MS Outlook in a high-volume environment.
• Comfortable in interdisciplinary team environments with physicians, RNs, social workers.
• Knowledge of CMS and DHCS regulations related to PACE eligibility and NFLOC.
• Ability to collaborate with Site Medical Directors across multiple CA sites.
• Experience presenting complex cases to Medical Directors.
• Cultural competence with diverse elderly populations.

Responsibilities

• Conduct thorough chart reviews for PACE applicants, documenting medical history, function, and eligibility factors.
• Present cases to Site Medical Directors per guidelines to support informed decisions.
• Collaborate with Enrollment RNs and Directors to fill documentation gaps before submission.
• Provide clinical input for Health & Safety determinations and conduct virtual assessments when needed.
• Review ILOC summaries to ensure clear links between conditions, function, and PACE services.
• Support quality initiatives to maintain DHCS approval rates and reduce deficiencies.
• Serve as clinical resource for Pre-Enrollment on complex cases and chart accuracy.

Skills

California NP/PA license

DEA certification

Geriatrics experience

Chart review

Geriatric assessment tools

ILOC documentation

Epic EHR

Interdisciplinary teamwork

CMS/DHCS regulations

Collaboration across sites

Presenting cases

Cultural competence

Tools

Epic EHR

Microsoft Outlook

Job description

Remote

Habitat Health empowers older adults to experiencemore gooddays in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, andin ‑ homeassistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and complex needs of aging populations, ourmission ‑ drivencare teams continue to help participants live well on their own terms.

Habitat Health is supported by leading healthcare organizations and investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a better model of care for older adults. To learn more, visit www.habitathealth.com.

Role Scope:We are looking for clinically outstanding clinician and detail-oriented Nurse Practitioner or Physician Assistant to join our centralized Pre-Enrollment team. This role reports directly to the Chief Medical Officer, with a dotted-line relationship to the Pre-Enrollment Director. You will serve as the clinical backbone of our chart review process, working hand in hand with Site Medical Directors across all Habitat Health PACE locations to ensure every case is thoroughly evaluated for PACE eligibility and Health & Safety (H&S) considerations before enrollment.

Location: Remote

Core Responsibilities & Expectations for the Role:
• Conduct thorough and complete chart reviews for PACE applicants, evaluating medical records, diagnostic history, functional status, and clinical documentation to capture all factors relevant to eligibility determination and potential H&S denial
• Present cases to Site Medical Directors as needed based on departmental guidelines and policy, ensuring all clinical findings are clearly communicated to support informed eligibility decisions
• Collaborate closely with Enrollment RNs (ERNs) and Site Medical Directors to ensure documentation gaps are identified and resolved prior to submission; serve as the escalation point when ERNs are unable to obtain required diagnostic information
• Provide clinical expertise for Health & Safety determinations, including participation in H&S Committee meetings; when chart review reveals diagnostic gaps that cannot be resolved by the ERN, conduct virtual clinical assessments to obtain or confirm required diagnoses and ensure chart completeness prior to submission
• Review ILOC clinical summaries to ensure clear connections between medical conditions, functional limitations, and PACE services are documented to regulatory standard
• Support quality improvement initiatives aimed at maintaining high first-pass DHCS approval rates and reducing documentation deficiencies
• Serve as a clinical resource for the Pre-Enrollment team on complex cases, supporting accuracy and thoroughness in ILOC documentation to protect the organization's H&S denial integrity

California NP Practice Note: Nurse Practitioners at Habitat Health PACE practice collaboratively with Site Medical Directors and the CMO in accordance with California Business and Professions Code §2746 and AB 890 provisions. This role operates within a collaborative physician-NP model consistent with Habitat Health PACE's interdisciplinary care framework.

Required Qualifications:
• Current, unrestricted Nurse Practitioner (NP) or Physician Assistant (PA) license in California
• Current DEA certification and furnishing/prescriptive authority in California
• Minimum 3 years of post-licensure NP clinical experience in geriatrics, long-term care, or PACE-adjacent setting
• Demonstrated chart review proficiency: ability to capture all factors relevant to PACE eligibility and H&S denial determinations
• Competency with geriatric assessment tools: BIMS, PHQ-9, MoCA, MMSE, ADL/IADL scales
• Strong ILOC documentation skills meeting California Title 22 and 42 CFR Part 460 standards
• Proficiency with Epic EHR and Microsoft Outlook; ability to manage high-volume time-sensitive communication in a fast-paced department
• Experience working in interdisciplinary team environments with physicians, RNs, and social workers
• Understanding of CMS and DHCS regulations related to PACE eligibility and NFLOC criteria
• Ability to practice collaboratively with Habitat Health PACE Site Medical Directors across multiple California sites
• Experience presenting complex cases to Medical Directors in a fast-paced clinical environment
• Cultural competence and experience working with diverse elderly populations

Nice to have:
• Previous experience in PACE or similar programs serving older adults with complex needs; prior experience in a lead clinical role or informal leadership capacity is a plus
• Proficiency with telehealth and virtual assessment methodologies, including willingness to conduct virtual clinical assessments when diagnostic gaps require direct provider evaluation
• Familiarity with DHCS ILOC submission process and Health & Safety committee frameworks
• Knowledge of behavioral health assessment in geriatric populations
• Experience with care transitions between different levels of care
• "Adult-Gerontology Primary Care Nurse Practitioner population focus preferred, or active pursuit of certification."
• "Adult-Gerontology Acute Care Nurse Practitioner (AGPCNP) population focus preferred, or active pursuit of certification."
• Bilingual Spanish/English — strongly preferred

Essential Functions & Physical Requirements
The following statements describe the general nature of work and physical expectations common across roles at Habitat Health. Specific responsibilities may vary by position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Team members in this role may be expected to
• Work in healthcare, administrative, community, or remote environments, depending on role needs.
• Remain stationary and/or move about for extended periods, consistent with job duties.
• Operate standard office equipment and/or clinical tools (e.g., computers, phones, medical devices, documentation systems).
• Travel between work sites or community locations as needed.
• Follow safety procedures, infection control protocols, and use personal protective equipment (PPE) when required.
• Perform tasks that may involve bending, reaching, lifting, or assisting participants, depending on role responsibilities.
• Lift, carry, push, or pull supplies, equipment, or materials typically up to 25–50 pounds, with assistance or mechanical aids, depending on job duties and role responsibilities.

Compensation:
The anticipated base salary range for this position is $116,000 - $152,000. This position is also eligible for a target annual bonus of 10% and may be eligible for additional incentive compensation, as applicable.
The final compensation offered will be determined based on factors including, but not limited to, the candidate's qualifications, skills, experience, education, certifications, geographical location, and business needs.
In addition, this position is eligible for a comprehensive benefits package, including medical, dental, and vision insurance; paid parental leave, short- and long-term disability coverage; life insurance; flexible spending accounts; a 401(k) savings plan that includes a match; paid time off; and company paid holidays.

At-Will Employment
Employment with Habitat Health is at-will. This means that either the employee or the employer may terminate the employment relationship at any time, with or without cause, and with or without notice, subject to applicable law. Nothing in this job posting or any other company document is intended to create a contract of employment, express or implied, or to alter the at-will nature of employment.
Any written or oral statements to the contrary are not authorized unless made in writing and signed by an authorized representative of the Company.
Because this is a remote position, employment will be governed by the laws applicable to the employee’s work location, and applicable legal requirements will be followed.

To helpmaintaina safe environment for our participants and team members, Habitat Healthmaintainsvaccination and infection control policies applicable to certain roles and work locations. For COVID-19 and influenza, team members who are working in a participant care setting are required to provide either proof of vaccination or a signed declination form and comply with applicable masking requirements while in a care setting to the extent permitted by law in the applicable jurisdiction.

Habitat Health will consider requests for reasonable accommodation based on an applicant's disability, medical condition, orsincerely heldreligious belief, practice, or observancein accordance withapplicable law.

As a condition of employment, team members are expected to comply with all applicable infection control protocols, personal protective equipment (PPE) requirements, and vaccination requirements associated with their role and work location, and to the extent required by law and as permitted in the applicable jurisdiction.

Our Commitment to Equal Opportunity and Inclusion

Habitat Health is an Equal Opportunity Employer committed tothe principles of equal opportunity and inclusion.Employment decisions at Habitat Health are based on qualifications, merit, and business needs. We do not discriminate on the basis of race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding, and related medical conditions), gender identity, gender expression, sexual orientation, marital status, registered domestic partner status, age, national origin, ancestry, citizenship, military or veteran status, physical or mental disability, medical condition, genetic information, reproductive health decision-making, or any other characteristic protected by applicable federal, state, or local law.

Habitat Health is committed to the full inclusion of all qualified individuals. Consistent with applicable law, we provide reasonable accommodations to qualified individuals with disabilities and to individuals with religious beliefs, practices, or observances that require accommodation.

If you requirea reasonableaccommodation toparticipatein the application or interview process, perform the essential functions of a position, or receive other employment benefits and privileges, please contact us at [e-mail] .

We encourage individuals from all backgrounds to apply, even if their experience does not align perfectly with every qualification listed.

Habitat Healthparticipatesin E-Verify and will provide the federal government with information from your Form I-9 to confirm your authorization to work in the United States.

If E-Verify cannot confirm your authorization to work, Habitat Health will provide you with written instructions and an opportunity to contact the Department of Homeland Security (DHS) and/or the Social Security Administration (SSA) to resolve the issue before any adverse employment action is taken, including termination of employment.

E-Verify is used only after an applicant has accepted an offer of employment and completedthe FormI-9and to the extentpermittedbyapplicable law.

Habitat Healthcomplies withall federal and state employment eligibility verification requirements.

Beware of Scams and Fraud

Habitat Health is committed to protecting job seekers from recruitmentscams. Please ensure that yousubmitapplications only through Habitat Health's official careers website or authorized job boards.

Official communications from Habitat Health recruiters and team members will come from email addresses ending in @habitathealth.com. Habitat Health will never ask applicants to pay fees,purchaseequipment, or provide sensitive financial information as part of the recruiting or hiring process.

If you receive suspicious communications claiming torepresentHabitat Health, we encourage you to exercise caution and independently verify the communication before responding.

If you believe you have been the victim of a recruitmentscamor fraudulent job posting, please report the incident to the Federal Trade Commission (FTC) through its fraud reporting website at reportfraud.ftc.gov.

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