Position OverviewThe Nurse Practitioner (NP) will have oversight of a unique membership population requiring specialized chronic disease management. This position requires clinical expertise supporting patients with hematology, rheumatology, and gastrointestinal conditions.
The Nurse Practitioner serves as a key clinical leader within the Ponos Care model, delivering patient centered care through a hybrid environment that includes telehealth services and in home patient visits within a 30-mile radius of the Northwest/Southwest counties/cities areas in the state of Virginia.
The NP collaborates closely with physicians, social workers, nurses, and care coordinators to ensure patients receive comprehensive and coordinated care.
Core ResponsibilitiesPatient Care- Provide comprehensive clinical care to patients with conditions such as Sickle Cell Disease, Crohn's Disease, and severe rheumatoid arthritis.
- Conduct comprehensive health assessments including physical examinations, medical history reviews, and diagnostic evaluations.
- Develop and implement individualized care plans for chronic disease management.
- Conduct telehealth consultations and in-house visits to evaluate patient progress and clinical outcomes.
- Prescribe medications and treatment plans in accordance with state licensing requirements.
- Provide ongoing monitoring and follow up care to ensure treatment effectiveness.
Patient Education- Educate patients and their families on disease management, treatment plans, medication adherence, and self-care strategies.
- Promote preventative care practices and patient engagement in long term health management.
Care Coordination- Collaborate with physicians, nurses, social workers, and partner healthcare organizations to ensure seamless care coordination.
- Work closely with the Chief Medical Officer and clinical leadership team to support clinical program development and care delivery models.
Documentation- Maintain accurate and timely documentation within the electronic health record system.
- Ensure patient documentation aligns with regulatory requirements and organizational policies.
- Participate in quality improvement initiatives to enhance patient outcomes and care delivery processes.
QUALIFICATIONS AND EDUCATION- Certified Nurse Practitioner with an unrestricted license to practice in the Commonwealth of Virginia.
- Minimum of three years of clinical experience, preferably supporting chronic disease populations.
- Clinical experience in hematology, rheumatology, or gastroenterology populations preferred.
- Strong clinical assessment and diagnostic capabilities.
- Excellent communication and interpersonal skills.
- Ability to work independently and within a multidisciplinary team environment.
- Proficiency in electronic health records and healthcare technology platforms.
- Commitment to delivering high quality patient-centered care.
- Bilingual skills are a plus.
- Must reside in the State of Virginia
- Must be able to travel to Pulaski, Floyd, Franklin, Giles, Grayson, Henry Lee, Montgomery, Patrick and Wythe Counties in the state of Virginia.
