In-Home NP/PA: Chronic Care Specialist

Monogram Health; Trenton (NJ); On-site; USD 102,211 - 169,123; Full time

Benefits offered by this job

Competitive base salary

Annual anniversary bonus

Mileage reimbursement

CEU/CME expense reimbursement

PTO 15 days + 7 holidays + 1 float

Job summary

Monogram Health is seeking Advanced Practice Providers (NPs or PAs) to deliver high-quality in-home care for patients with multiple chronic conditions. This role collaborates with a multidisciplinary team and participates in telehealth when appropriate.

You will conduct initial and follow-up assessments, manage medications, and coordinate with PCPs and specialists. The position involves travel to patient homes in a value-based care model to improve outcomes.

Qualifications

• Active and unrestricted RN/NP/PA license or equivalent.
• Board certification in respective clinical role.
• DEA certificate active or eligible.

Responsibilities

• Provide patient-centered in-home care reducing hospitalizations.
• Perform comprehensive assessments and follow-up visits.
• Educate patients and caregivers on disease management and medications.
• Participate in integrated care team meetings.
• Coordinate care with PCPs and specialists.
• Complete timely documentation.

Skills

Compassionate care

Communication skills

Independence/initiative

Critical thinking

Travel to patient homes

EHR experience (Athena Salesforce Epic

Education

Active RN/NP/PA license

Board certification (NP: ANCC/AANP | PA: NCCPA)

DEA certificate (or eligibility)

Tools

Athena

Salesforce

Epic

Job description

Monogram Health is seeking Advanced Practice Providers (NPs or PAs) to deliver high-quality in-home care for patients with multiple chronic conditions. This role collaborates with a multidisciplinary team and participates in telehealth when appropriate.

You will conduct initial and follow-up assessments, manage medications, and coordinate with PCPs and specialists. The position involves travel to patient homes in a value-based care model to improve outcomes.