Nurse Practitioner Community Care

Blue Ridge Care; Winchester (VA); On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Retirement with Company Match

Paid Time Off

Paid Volunteer Time

Thrift Shop Discount

Employee Wellness Benefits including,‑

Calm App

Job summary

Blue Ridge Care seeks a Nurse Practitioner to join our Community Care division in Virginia. Under the Medical Director, you will deliver proactive, patient-centered care to older adults with chronic conditions to reduce hospitalizations and support long-term wellness.

You will perform comprehensive assessments, develop individualized care plans with the interdisciplinary team, monitor progress (including remote monitoring), and coordinate care with providers and resources.

Qualifications

• Must hold an active Virginia Nurse Practitioner license.
• Minimum of two years of clinical practice with frail or elderly populations is preferred.
• Strong care coordination and patient engagement skills required.

Responsibilities

• Perform comprehensive assessments for chronic conditions (e.g., diabetes, hypertension).
• Develop individualized care plans with the interdisciplinary team.
• Monitor patient progress, including remote monitoring where applicable; adjust treatment plans.
• Coordinate care across providers and community resources to ensure continuity.
• Utilize telehealth and EHRs to document care and communicate with patients.

Skills

Care coordination

Telehealth

EHR systems

Patient education

Clinical assessment

Communication

Education

Virginia NP license

Tools

EHR platforms

Telehealth platforms

Job description

ABOUT BLUE RIDGE CARE SERVICES

Blue Ridge Care works to optimize the quality of life and well‑being for those members of our community affected by aging or dealing with chronic or serious illness. With a mission of brightening life’s journey for all whom we are privileged to serve, and a strategic goal to grow and expand our services to continue meeting the evolving healthcare needs of the community, Blue Ridge is “Caring for life”.

POSITION SUMMARY

Under the direction of the Medical Director for Community Care, Nurse Practitioners play a pivotal role in delivering proactive, patient‑centered care that reduces hospitalizations, enhances quality of life, and supports long‑term wellness.

ESSENTIAL DUTIES & RESPONSIBILITIES

• Conducts comprehensive assessment for patients with chronic conditions (e.g., diabetes, hypertension, COPD, heart failure)
• Develops individualized care plans in collaboration with the interdisciplinary care team
• Monitors patient progress, in some cases utilizing remote patient monitoring. Adjusts treatment plans and provides ongoing education and support
• Coordinates care across providers, specialists, and community resources to ensure continuity
• Utilizes telehealth platforms and electronic health records to document care and communicate with patients
• Participates in quality improvement initiatives and contributes to program development
• Ensures compliance with CMS guidelines for CCM billing and documentation
• Participates in on‑call rotation in Community Care Division
• Acts within the scope of his or her authority to practice
• Follows all OSHA safety guidelines
• Protects privacy and maintains confidentiality of all company procedures, results and information about employees, patients and families
• Handles potentially infectious specimens with appropriate biohazard precautions, and practices Universal Precautions
• Participates in continuing education classes and any required staff and training meetings. Maintains professional affiliations and any required certifications
• Participates in and supports quality improvement initiatives
• May be cross‑trained as a nurse practitioner within the Community Care division
• Performs other duties as required

ESSENTIAL REQUIREMENTS

• Must have medical clearance for communicable diseases and up‑to‑date immunizations before having direct patient contact
• Must have a valid driver’s license and have means of transportation
• Must clear the background check
• Must have an active and unrestricted Nurse Practitioner license in Virginia
• A minimum of two years of clinical practice working with the frail or elderly population
• Must have strong understanding of care coordination and patient engagement strategies
• Must be proficient in EHR systems and telehealth platforms
• Excellent communication, critical thinking and organizational skills

BENEFITS

• Health Insurance
• Dental Insurance
• Vision Insurance
• Employee Wellness Benefits including Employee Assistance Plan, Calm App, Self Care Days
• Retirement with Company Match
• Paid Time Off
• Paid Volunteer Time
• Thrift Shop Discount

Blue Ridge Care is a non‑profit, equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees and patients served.