Nurse Practitioner - Medicare Advantage & HCC Risk Adjustment

Universal Health Services; McAllen (TX); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Generous Paid Time Off

Excellent Medical, Dental, Vision and

Prescription Drug Plans

401(K) with company match and stock

SoFi Student Loan Refinancing Program

Career development opportunities

Job summary

Prominence Health, part of Universal Health Services, seeks a Nurse Practitioner to perform comprehensive health assessments for Medicare and Commercial patients, ensuring accurate clinical documentation and management of chronic conditions.

The ideal candidate has experience with Medicare Advantage health assessments, CMS risk adjustment, and documentation of quality measures under HEDIS and Stars, and is able to travel within Texas when needed. Bilingual English/Spanish preferred.

Qualifications

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

Responsibilities

• Perform comprehensive health assessments for Medicare and Commercial patients with accurate clinical documentation.
• Manage chronic conditions and preventive services with CMS risk adjustment of the V28 model, ensuring HEDIS/Stars quality measures compliance.

Skills

Health insurance industry experience

Managed care experience

EMR proficiency

Documentation accuracy

Bilingual English/Spanish

Travel within Texas

Education

Master’s degree in Nurse Practitioner's program

Texas RN license

National NP certification

Job description

Prominence Health, part of Universal Health Services, seeks a Nurse Practitioner to perform comprehensive health assessments for Medicare and Commercial patients, ensuring accurate clinical documentation and management of chronic conditions.

The ideal candidate has experience with Medicare Advantage health assessments, CMS risk adjustment, and documentation of quality measures under HEDIS and Stars, and is able to travel within Texas when needed. Bilingual English/Spanish preferred.