Nurse Practitioner

Dreams 2 Reality Recruitment; Kentucky; Hybrid; USD 100,000 - 135,000; Full time

Job summary

Dreams 2 Reality Recruitment is seeking an experienced Nurse Practitioner to join a growing organization delivering home-centered, value-based care in Ohio. The role emphasizes proactive care management, telehealth, and coordination for medically complex adults and geriatric patients.

You will work with an interdisciplinary team and leverage telehealth to keep patients safely at home, with potential hybrid office presence as the organization expands in Ohio.

Qualifications

• Master’s degree or higher in Nursing or a related field.
• Current and active Nurse Practitioner license in Ohio, or ability to obtain Ohio licensure.
• Current Family Nurse Practitioner (FNP) or Adult/Adult-Gerontology Nurse Practitioner (AGNP) certification.
• Minimum 3 years of primary care experience; 3–5 years preferred.
• Ability to practice autonomously within scope of practice and prescriptive authority.
• Experience caring for medically complex adult and/or geriatric patients.
• Experience with telehealth, virtual care, remote patient monitoring, or remote care management.
• Knowledge of or experience with HCC coding and risk adjustment.
• Familiarity with STAR and HEDIS quality measures.
• Experience participating in advance care planning and goals-of-care discussions.
• Strong clinical judgment, communication, collaboration, and relationship-building skills.
• Ability to work independently while collaborating within an interdisciplinary care team.

Responsibilities

• Provide clinical care and ongoing patient management through telehealth and remote care technologies.
• Manage and coordinate care for medically complex adult and geriatric patients.
• Partner with physicians and an interdisciplinary team to develop and implement individualized care plans.
• Build strong relationships with patients, families, caregivers, and health plan partners.
• Monitor changes in patient health and intervene to reduce hospitalizations.
• Support patients through hospital admissions, discharges, and transitions home.
• Participate in advance care planning and goals-of-care discussions.
• Participate in shared clinical triage and team-based support processes.
• Identify and address barriers to care and adherence.
• Support quality improvement with accurate clinical documentation.
• Contribute to HCC coding, risk adjustment, STAR, and quality-gap initiatives.
• Help develop clinical best practices within an evolving care model.
• Promote patient independence, safety, and quality of life through care coordination.

Skills

Telehealth

HCC coding

STAR/HEDIS

Advance care planning

Interdisciplinary care

Care coordination

Autonomy

Communication

Education

Master’s degree or higher

Ohio NP license

FNP or AGNP certification

Job description

Focus: Primary Care | Complex Care Management |Telehealth
Location: Ohio
Work Arrangement: Remote
Experience: 3 Years of Primary Care Experience
Education: Master’s Degree or Higher

We are seeking an experienced Nurse Practitioner (NP)to join a growing healthcare organization focused on delivering innovative,patient-centered care to medically complex populations throughout Ohio.

This is an opportunity to move beyond the traditional clinicsetting and play a key role in a home-centered, value-based model of care.The position focuses on proactive care management, early intervention, carecoordination, and improving outcomes for patients who often require a higherlevel of clinical support.

The Nurse Practitioner will work as part of a collaborativeinterdisciplinary team that may include physicians, Nurse Practitioners,Registered Nurses, Licensed Clinical Social Workers, therapists, and otherhealthcare professionals.

Through telehealth, remote care management, andcoordinated clinical services, the team works closely with patients,families, caregivers, primary care providers, specialists, and health planpartners to help patients remain healthy and safely at home.

The patient population may include Medicaid and DualEligible members, including individuals with:

• Complexchronic medical conditions.
• Traumaticbrain injuries.
• Functionallimitations.
• Medicallycomplex and aging populations.
• Multiplechronic conditions requiring coordinated care.

The role is primarily virtual, with the potential for acollaborative office presence in a major Ohio metropolitan area as theorganization continues to expand.

Key Responsibilities

• Provideclinical care and ongoing patient management through telehealth andremote care technologies.
• Manageand coordinate care for medically complex adult and geriatric patientpopulations.
• Partnerwith physicians and interdisciplinary team members to develop andimplement individualized care plans.
• Buildstrong relationships with patients, families, caregivers, primary careproviders, specialists, and health plan partners.
• Monitorchanges in patient health and intervene proactively to reduce avoidableemergency department visits and hospitalizations.
• Supportpatients through hospital admissions, discharges, and transitions back tothe home setting.
• Participatein advance care planning and goals-of-care discussions withpatients and families.
• Participatein shared clinical triage and team-based support processes.
• Identifyand address barriers to care, treatment adherence, and patient engagement.
• Supportquality improvement initiatives through accurate and timely clinicaldocumentation.
• Contributeto HCC coding, risk adjustment, STAR, HEDIS, and quality-gap closureinitiatives.
• Participatein the development of clinical best practices and contribute to thecontinued evolution of an innovative care model.
• Promotepatient independence, safety, and improved quality of life throughproactive care coordination.

Required Qualifications

• Master’sdegree or higher in Nursing or a related field.
• Currentand active Nurse Practitioner license in Ohio, or ability to obtainOhio licensure.
• CurrentFamily Nurse Practitioner (FNP) or Adult/Adult-Gerontology NursePractitioner (AGNP) certification.
• Minimum3 years of primary care experience; 3–5 years of NursePractitioner experience preferred.
• Abilityto practice autonomously within applicable scope of practice and maintainappropriate prescriptive authority.
• Experiencecaring for medically complex adult and/or geriatric patients.
• Experiencewith telehealth, virtual care, remote patient monitoring, or remote caremanagement.
• Knowledgeof or experience with HCC coding and risk adjustment.
• Familiaritywith quality measures and programs, including STAR and HEDIS.
• Experienceparticipating in advance care planning and goals-of-care discussions.
• Strongclinical judgment, communication, collaboration, and relationship-buildingskills.
• Abilityto work independently while effectively collaborating within aninterdisciplinary care team.

Preferred Clinical Background

Candidates with experience in one or more of the followingareas are encouraged to apply:

• Value-BasedCare.
• PopulationHealth.
• Home-BasedPrimary Care.
• Geriatrics.
• ManagedMedicaid.
• CareManagement.
• EmergencyMedicine or Clinical Triage.
• HomeHealth.
• ComplexCare Management.

Why This Opportunity

This position is ideal for an experienced Nurse Practitionerwho wants to make a meaningful impact on the lives of medically complexpatients while working outside the traditional high-volume clinic environment.

Rather than focusing solely on the number of patients seen,this care model emphasizes proactive intervention, care coordination,prevention, quality improvement, and patient-centered outcomes.

You will have the opportunity to:

• Buildmeaningful relationships with complex patients and their families.
• Workcollaboratively with a multidisciplinary clinical team.
• Leveragetelehealth and technology to improve access and care coordination.
• Helpprevent avoidable hospitalizations and emergency department visits.
• Supportpatients in living safely and independently at home.
• Contributeto the development of an innovative, value-based healthcare model.
• Helpshape clinical processes and best practices as the organization grows inOhio.

If you are an experienced Nurse Practitioner seeking a mission-driven,collaborative, and innovative clinical opportunity, this role offers thechance to make a meaningful difference while helping transform how complexpatients receive care.