Nurse Practitioner

Prominence Health; McAllen (TX); On-site; USD 100,000 - 140,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Competitive Compensation

Excellent Medical, Dental, Vision

Job summary

Prominence Health is seeking a Nurse Practitioner to perform comprehensive health assessments for Medicare and Commercial patients in Texas. You will document chronic conditions, coordinate preventive services, and work within a value-based care framework.

The ideal candidate has NP certification, TX RN license, and experience with CMS risk adjustment and HEDIS/Stars metrics. Travel within Texas and collaboration with care teams are essential.

Qualifications

• Current Registered Nurse License in the State of Texas.
• Masters Degree from an accredited Nurse Practitioner's Program.
• National Certification as a Nurse Practitioner or certification preferred.

Responsibilities

• Performs comprehensive health assessments for Medicare and Commercial Patients ensuring accurate clinical documentation and management of chronic conditions and preventive services.
• Experience with Managed Care/Medicare Advantage health assessments and CMS risk adjustment documentation (V28); familiarity with HEDIS and Stars quality measures.

Skills

Health insurance industry experience

EMR experience

HCC risk adjustment knowledge

Quality improvement

Texas travel

Bilingual English/Spanish

Education

Masters in NP program

National NP certification (preferred)

TX RN license

Tools

EMR system

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary

Performs comprehensive health assessments for Medicare and Commercial Patients ensuring accurate clinical documentation and management of chronic conditions and preventive services

The ideal candidate has experience working in Managed Care /Medicare Advantage sponsored Health Assessments with emphasis on documentation of chronic conditions under the CMS risk adjustment V28 model. The provider has work experience with compliance and documentation of quality measures under HEDIS and Stars

Benefit Highlights

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!

More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Qualifications and Requirements:

Regulatory Requirements

• Current Registered Nurse License in the State of Texas.
• Masters Degree from an accredited Nurse Practitioner's Program.
• National Certification as a Nurse Practitioner or certification preferred.
• Current BLS Certification.

Skills

• Experience working in Health Insurance Industry or Managed Care Organizations
• Ability to work on a Electronic Medical Record (EMR)
• ICD- Documentation experience and HCC risk adjustment model
• Competence in Quality Improvement Programs and Measures
• Ability to travel within the State of Texas
• Ability to visit patients home with or without supporting staff
• Ability to communicate in English and Spanish, both verbally and in writing.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.