Palliative Nurse Practitioner / Physician Assistant

Monogram Health; Bastrop (LA); Remoto; USD 125.000 - 162.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision insurance

401(k) with employer match

Paid time off (20 days) + holidays

Descrizione del lavoro

Monogram Health is seeking a full-time Palliative Care Advanced Practice Provider to join in-home care delivery for highly complex patients across the community. The APP collaborates with Market Physician Executives and an interdisciplinary team to guide symptom management, care planning, and patient-family education while pursuing quality outcomes.

The role emphasizes autonomous practice, state-based remote work, and involvement in population-health driven care models with comprehensive

Competenze

• Active and unrestricted NP or PA license.
• 2+ years working in a palliative care setting.
• Ability to work without direct supervision and practice autonomously.
• Must possess reliable transportation and be able to travel within the designated region for in-home and clinic visits.

Mansioni

• Provide in-home palliative care with some virtual care, aligned with patient goals.
• Develop individualized care plans with clinical leaders to ensure evidence-based interventions.
• Evaluate and treat symptoms to improve quality of life.
• Educate patients and families on disease progression and care options.
• Document care coordination details with primary care and specialists.
• Participate in interdisciplinary team meetings and KPI reviews.
• Assist with transition to hospice when appropriate.

Conoscenze

Autonomy

Palliative care experience

NP/PA license

Formazione

Nurse Practitioner or Physician Assistant license

Strumenti

EHR proficiency

Descrizione del lavoro

Palliative Care Nurse Practitioner / Physician Assistant Monogram Health is seeking a full-time Palliative Care Advanced Practice Provider (APP) to join the team to support our rapid nationwide growth. This Palliative Care APP will be an in-market provider delivering in-home care for a highly complex patient population in their community, including end-of-life patients with CKD/ESRD, diabetes, COPD, and CHF. The Palliative Care APP will support the Market Physician Executive, the Palliative Care Lead Physician, and an interdisciplinary team to provide palliative care, clinical guidance to patients and their families, including pain and symptom management, develop appropriate care plans and document advance directives to ensure patient-centered care. Palliative Care APPs are quality-driven clinicians who apply their expertise in a managed care, population health context. They also engage in population health management in a sophisticated, outcomes-driven manner that promotes palliative care where clinically appropriate and focuses on patient quality of life, education, and shared-decision making. They will collaborate with our interdisciplinary Pod teams and field clinicians to enhance care integration and optimize palliative care delivery to complex patients through Monogram Health’s comprehensive polychronic care model. The base salary range for this role is $125,000 to $162,000 and reflects the range of experience and qualifications we may consider. In addition to base salary, this role is eligible for additional compensation, including bonus opportunities and a comprehensive benefits package.

• Collaborate with the Market Physician Executive and clinical leaders including Palliative Care physician to proactively identify patients who qualify for palliative care services and build a patient panel
• Develop individualized care plans in collaboration with Market Physician Executive and other clinical leaders including Palliative Care physician to ensure patients are placed on appropriate evidence-based interventions and pathways
• Provide compassionate, patient-centric palliative care primarily through in-home visits, with virtual care as needed, to support outcomes and care in alignment with patient’s goals
• Evaluate and treat symptoms that may interfere with quality of life, like pain, pruritus, depression, anxiety, insomnia, etc.
• Provide resources and educate patients and their families on the progression of CKD, ESKD, and related conditions, including treatment options and palliative care principles
• Help families navigate complex medical decisions and improve understanding of prognosis, including advance care planning to discuss values, goals of care, and document patient/family wishes in state AD/POLST forms
• Deliver evidence-based, timely care in a manner that reduces avoidable hospitalizations, maximizes quality of life, and puts patient health and satisfaction first
• Support patients utilizing our interdisciplinary team, including Palliative Care Chaplain
• Assist with transition to hospice care as appropriate
• Participate in monthly meetings with clinical leadership to drive Program KPIs and support execution of clinical and financial goals
• Educate and support team members on palliative care, hospice care, advance directives, symptom assessment, and communication
• As needed for patient care, conducts assessments, which includes comprehensive annual wellness exams on patients both in the patients’ home and in the virtual environment
• Counsels and educates patients and families about benefits and programs available to help them live healthier lives
• Documents items such as: appropriate chief complaint, all applicable diagnosis, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment, and plan. Responsible for the coordination of care with primary care providers, specialists, and appropriate ancillary services
• This position will not be office-based but will be remote in state in which employed and will need to attend periodic training/meetings outside of that state
• Prescribe medications, order tests, and collaborate with patient’s Monogram physician
• Perform effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily
• Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing
• Assists patients with enrolling to access educational videos
• Participates in the integrated care team meetings
• Make assessment of patient's health status and develop treatment plan
• Implement a plan consistent with patient’ goals of appropriate plan of care

• Active and unrestricted Nurse Practitioner or Physician Assistant license
• ~ Ability to work without direct supervision and practice autonomously
• ~ Must possess reliable transportation and the ability to travel within the designated region to meet patient needs including in-home and clinic visits as needed. Access to transportation, a valid driver’s license, and car insurance
• ~ 2+ years working with patients in a palliative care setting; Demonstrated experience in clinical assessment, care plan design, and evaluating patients using evidence-based clinical criteria
• Strong communication skills for sensitive conversations about prognosis and end‑of life decisions including goals of care discussions and advance care planning
• Proficiency with electronic health record (EHR) systems to document complex case details

• Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – 20 PTO days, 7 paid holidays, and 1 floating day to make your own, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

About Monogram Health

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.