Outpatient Complex Care NP – Chronic Disease Manager

AbsoluteCARE Medical Center & Pharmacy; Philadelphia (Philadelphia County); On-site; USD 110,000 - 140,000; Full time

Job summary

AbsoluteCARE Medical Center & Pharmacy in Philadelphia seeks a Complex Care Nurse Practitioner/Advanced Practice Provider to manage care for patients with multiple chronic conditions in an outpatient, team-based setting. You will perform assessments and coordinate care with social work, case management, pharmacy, and specialists.

The role emphasizes transitions of care, discharge planning, and collaboration with supervising physicians to optimize patient outcomes in CHF, COPD, HTN, diabetes, and

Qualifications

• Licensed Advanced Practice Provider in the state of practice.
• 2 years of experience as an Advanced Practice Provider in Primary Care.
• DEA license.
• ACLS certification.
• Experience with multiple chronic conditions (CHF, COPD, HTN, Diabetes).
• Experience with Medicare/Medicaid and commercial populations.

Responsibilities

• Manage and improve health for patients with multiple chronic conditions.
• Maintain a panel of 200–250 chronic care ambulatory patients.
• Collaborate with social work, case management, behavioral health, pharmacy, and nutrition.
• Develop transitional care plans and track patients through hospital discharge and home care.
• Facilitate appropriate discharge and care transitions with supervising physician.
• Treat acute exacerbations in outpatient settings with physician collaboration.
• Accept same-day/next-day urgent appointments from home or hospital discharge.

Skills

Care coordination

Chronic disease management

Team-based care

Assessment & evaluation

Patient counseling

Outpatient care

Education

APRN license (state)

DEA license

ACLS certification

Tools

eClinicalWorks

EMR literacy

Job description

AbsoluteCARE Medical Center & Pharmacy in Philadelphia seeks a Complex Care Nurse Practitioner/Advanced Practice Provider to manage care for patients with multiple chronic conditions in an outpatient, team-based setting. You will perform assessments and coordinate care with social work, case management, pharmacy, and specialists.

The role emphasizes transitions of care, discharge planning, and collaboration with supervising physicians to optimize patient outcomes in CHF, COPD, HTN, diabetes, and