Complex Care Advanced Practice Provider: Chronic Disease

AbsoluteCARE Medical Center & Pharmacy; Baltimore (MD); On-site; USD 105,000 - 145,000; Full time

Job summary

AbsoluteCARE Medical Center & Pharmacy in Baltimore seeks an Advanced Practice Provider to lead complex care management in the outpatient setting. You will counsel patients, perform assessments, coordinate with multidisciplinary team, and implement evidence-based plans of care for chronic conditions, with emphasis on PCMH principles and care transitions.

Responsibilities include managing a panel of chronic care patients, collaborating with physicians, social work, case management, and other

Qualifications

• Licensed Advanced Practice Provider in the state of practice.
• ACLS certification.
• Minimum of 2 years experience as an Advanced Practice Provider.
• Experience with Medicare, Medicaid, and commercial populations.
• Knowledge of chronic disease management programs and services.
• Excellent organization and communication skills.
• Comfortable with outpatient settings offering IV hydration/antibiotics with physician collaboration.
• Proficiency with EMR, eClinicalWorks preferred.
• Knowledge of managed care and insurance processes is preferred.

Responsibilities

• Counsel patients on appropriate care settings and perform assessments.
• Manage and improve health for patients with multiple chronic conditions.
• Develop transitional care plans and track patients across care continuum.
• Coordinate with social work, case management, behavioral health, pharmacy, and nutrition.
• Educate patients on chronic diseases and advanced directives.
• Participate in multidisciplinary meetings and report to Medical Director.

Skills

Chronic disease management

Care coordination

Team collaboration

Patient education

Evidence-based medicine

EMR proficiency

Education

Licensed Advanced Practice Provider

ACLS certification

Tools

eClinicalWorks EMR

Job description

AbsoluteCARE Medical Center & Pharmacy in Baltimore seeks an Advanced Practice Provider to lead complex care management in the outpatient setting. You will counsel patients, perform assessments, coordinate with multidisciplinary team, and implement evidence-based plans of care for chronic conditions, with emphasis on PCMH principles and care transitions.

Responsibilities include managing a panel of chronic care patients, collaborating with physicians, social work, case management, and other