In-Home Advanced Practice NP/PA — Value-Based Care Champion

Monogram Health Professional Services; California (MO); Hybrid; USD 130,000 - 169,000; Full time

Benefits offered by this job

Mileage reimbursement

CEU/CME reimbursement

20 PTO days

7 paid holidays

Floating day

Annual anniversary bonus

Up to 15% bonuses

401k with employer match

Medical, dental, vision

Job summary

Monogram Health seeks an Advanced Practice Provider (NP/PA) to deliver in-home care for patients with multiple chronic conditions. You will join an integrated care team and build long-term patient relationships in homes and via telehealth, with a value-based, patient-centered approach.

The role offers a base salary with incentives, mileage reimbursement, CEU/CME reimbursement, and annual bonuses. Travel to patient homes is required, and a strong focus on quality care and professional growth is

Qualifications

• Active and unrestricted RN and NP license, or Physician Assistant license.
• Board certification (NP: ANCC/AANP | PA: NCCPA).
• Current and unrestricted DEA certificate, or eligibility to obtain.
• Minimum of two (2) years of direct patient care experience.
• Field-based role requiring travel to patient homes, reliable transportation, valid driver’s license, and auto insurance.
• Demonstrated initiative and independent, critical thinking, and decision-making skills.
• Knowledge of federal/state regulations (HIPAA, OSHA).
• Prior experience with EHR systems (Athena, Salesforce, Epic).
• Background in managed care, population health, or value-based care preferred.

Responsibilities

• Provide evidence-based, patient-focused care that reduces avoidable hospitalizations and improves quality of life directly in the patient’s home.
• Perform comprehensive assessments, including initial evaluations, annual wellness exams, follow-ups, acute urgent visits, and post-discharge visits.
• Educate patients and caregivers on disease management, preventive care, medications, and diagnostic testing.
• Participate in recurring virtual integrated care team meetings.
• Engage in quality assurance activities, including audits and documentation reviews, to ensure compliance with state board requirements and clinical best practices.
• May practice in a variety of care settings beyond the patient’s home, including SNFs, ALFs, hospitals, and other affiliated clinical settings, as applicable.
• Perform point-of-care testing (A1C and Spirometry), prescribe medications, order tests, and collaborate with patient’s Monogram physician.
• Coordinate care with PCPs, specialists, and ancillary services.
• Complete documentation accurately and in a timely manner

Skills

RN license

NP license

PA license

Board certification NP

Board certification PA

DEA certificate

EHR proficiency

Travel to patient homes

Critical thinking

Tools

Athena

Salesforce

Epic

Job description

Monogram Health seeks an Advanced Practice Provider (NP/PA) to deliver in-home care for patients with multiple chronic conditions. You will join an integrated care team and build long-term patient relationships in homes and via telehealth, with a value-based, patient-centered approach.

The role offers a base salary with incentives, mileage reimbursement, CEU/CME reimbursement, and annual bonuses. Travel to patient homes is required, and a strong focus on quality care and professional growth is