- Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing
- Understands and complies with long-term care policies and procedures, including those that regulate nursing facilities and assisted living communities
- Establishes and maintains effective relationships with members and their legal representatives, facility staff, PCPs and other collaborating physicians/providers
- Performs an initial comprehensive assessment on all newly enrolled members and bi-annually thereafter. Develops a member management care plan upon enrolment and updates it as needed when changes in condition warrant or following hospitalization. Meets with members and/or their legal representatives to review newly developed or modified care plans; involves the PCP in these meetings
- Completes follow-up and post-hospital assessments according to documented standard operating procedure
- Prescribes appropriate diagnostics and interventions to avoid unnecessary transfers/acute admissions
- Consults with hospital physicians following notification of member transfer
- Collaborates with UM staff and PCPs/facility staff to enable medical necessity determinations for requested medical services
- Educates members and/or their legal representatives in disease processes affecting members and ways to manage them effectively, as well as to promote wellness
- Provides counsel, support and education to facility staff
- Supports FCMs in developing and providing in-service educational programs to facility staff
- Participates in management meetings that include, but may not be limited to:
- Weekly case conference reviews
- Monthly staff meetings
- Schedule Joint Operating Committee meetings
- Quarterly Quality Improvement Committee meetings
- Continuing education/journal club programs
- Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery
- On-call for caseload during business hours. May require some participation in clinical on-call program as plan expands
- Keeps current on relevant medical and nursing research, technology, and related issues by attending continuing education courses, professional meetings and journal reviews
- Perform related duties as necessary and other duties as assigned
- Completion of Nurse Practitioner or Physician Assistant accredited program
- Current state RN license if Nurse Practitioner
- Current NP or PA license
- Certification through the American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), or the National Commission on Certification of Physician Assistants (NCCPA)
- Knowledge of long-term care, community resources and cost-effective alternatives regarding patient care delivery systems
- Access to reliable transportation; if you are driving a vehicle, you must comply with all the terms of the Landmark Motor Vehicle Safety policy
- 2+ years of clinical experience
- Knowledge of CPT, ICD-9 and HCPC codes
- Knowledge of clinical standards of care
- Awareness NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems
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Primary Care position in Richmond Virginia
1 week ago
All Star Recruiting Richmond, United StatesWell-established practice is seeking Primary Care Physicians to practice adult medicine only in Richmond, VA JOB ID 65418 · Job Details: · BE or BC · Must have excellent interpersonal skills to communicate clearly and concisely with all levels of nursing, physicians, and admin ...
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LifeStance Health Richmond, United States Full timeAt LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives by improving access to trusted, affordable, and personalized mental healthcare. E ...
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Medicus Healthcare Solutions Richmond, United States Full time**Opportunity Details** · A group in northern Virginia has remote positions for Radiologists to join their team. · Advance your career with a reputable team dedicated to providing quality care to multiple facilities in Virginia. · **Position Highlights:** · * Shift Information: 1 ...
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Medicus Healthcare Solutions Richmond, United States Full time**Opportunity Details** · Optimum has new positions for Body Imagers to join an established group in northern Virginia. · Enjoy residing in a vibrant, family-friendly community with plenty of outdoor activities, delicious local eateries, and nearby attractions to explore · **Posi ...
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Soliant Richmond, United StatesMinimum 1+ years imaging experience required. · Soliant Health is hiring for an MRI Tech for 13 week assignment in the beautiful Richmond, Virginia · Overview: · ARRT, & BLS required · Possible extension · 13 week contract · If you are on the market for a position or just curious ...
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Soliant Richmond, United StatesMinimum 1+ years imaging experience required. · Soliant Health is hiring for an MRI Tech for 13 week assignment in the beautiful Richmond, Virginia · Overview: · ARRT, & BLS required · Possible extension · 13 week contract · If you are on the market for a position or just curious ...
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Curative Executive Search Richmond, United States Full time**Curative Executive & Academic Search has partnered with VCU Health and the · VCU School of Medicine in Richmond, Virginia on the national search for an · experienced academic and clinical leader in endocrinology to serve as the · _Chief of the Division of Endocrinology, Diabete ...
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Sentara Medical Group Richmond, United States Full time**Sentara Community Care** was created with the intent to invent new and unique models of care that strive to not only address but aid in alleviating some of the socially determined health disparity in our under-resourced communities. Since 2022, this program has expanded rapidly ...
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Aequor Locums Richmond, United States TEMPORARYGood afternoon · I'm working with an Amazing client on some Emergency Medicine opportunities in Virginia. Here are a few details. · - 32,000 Volume · - APP Coverage · - EMR: Meditech · - All shift times available · - Rate starting at $350hr · I would love to connect and discuss m ...
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Foster Crown, LLC Richmond, United States Full timeFoster Crown: Interventional Radiologist, Interventional Cardiologist, Vascular Surgeon: Richmond, VA, Indianapolis, IN & Columbus, GA · Are You Ready To Make Your Own Schedule and Practice Medicine in an Outpatient Setting? · - **Part-Time or Full-Time Options Available: M – F, ...
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LifeStance Health Richmond, United States Full timeAt LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives by improving access to trusted, affordable, and personalized mental healthcare. E ...
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Talkiatry Richmond, United States Full timeTalkiatry is currently seeking Staff Psychiatrists to join our Virginia based team of licensed providers as we expand into the market. We provide in-network, outpatient treatment for children & adults with depressive, anxiety, attention & other disorders. Talkiatry aims to bridge ...
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CareerPhysician, LLC Richmond, United States Full timeDivision Chief, Child Development · **Legacy Leadership Opportunity with Tremendous Resources** · On behalf of Shari Barkin, MD, MSHS, Professor and Chair, Department of Pediatrics at Virginia Commonwealth University (VCU) and Pediatrician-in-Chief, Children's Hospital of Richmon ...
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Soliant Richmond, United StatesMinimum 1+ years speech therapy experience required. · Qualifications: · Associate's degree in Speech-Language Pathology Assistant or equivalent · Valid Virginia state licensure or eligibility for licensure as an SLPA · Previous experience in educational or clinical settings pr ...
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Contract Administration Specialist
1 week ago
Virginia Passenger Rail Authority Richmond, United StatesThe Virginia Passenger Rail Authority (VPRA) is a political subdivision established by Chapter 1230 of the 2020 Acts of Assembly. VPRA is responsible for promoting, sustaining, and expanding the availability of passenger and commuter rail services in the Commonwealth, including a ...
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Orthodontic Dental Assistant- Traveling
1 week ago
Virginia Family Dentistry Richmond, United StatesFor over 45 years, Virginia Family Dentistry has been proudly providing safe, quality dental care to the greater Richmond area. We are a practice with almost 500 employees, 16 locations and over 60 general dentists and dental specialists. Although we are large, we operate like a ...
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Vice President Donated Goods Operations
7 hours ago
GOODWILL OF CENTRAL AND COASTAL VIRGINIA INC Richmond, United States**Vice President, Donated Goods Retail **_(Goodwill of Central and Coastal Virginia, Richmond VA)_** · This is a rare opportunity for the right Goodwill Donated Goods leader to join one of the best-performing Goodwill's in the network. If you're ready to join an outstanding team ...
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Computer Operations Associate
3 days ago
Virginia Lottery Richmond, United States**Title**: Computer Operations Associate · **State Role Title**: Computer Operations Associate · **Hiring Range**: $55,000 to $62,000 · **Pay Band**: UG · **Agency**: Virginia Lottery · **Location**:VAL RICHMOND DATA CENTER · **Recruitment Type**: General Public - G · **Job Dutie ...
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Virginia Commonwealth University Richmond, United States**Summary**: · The Virginia Commonwealth University (VCU) School of Dentistry is located in downtown Richmond, Virginia. With a 130-year history, Virginia's only dental school provides opportunities for selected, qualified individuals to study dentistry and oral health through a ...
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Pediatric Clinical Geneticist, F30680
1 week ago
Virginia Commonwealth University Richmond, United States**Mission or Goal of Unit**:Children's Hospital of Richmond of the Virginia Commonwealth University Health System has devoted to excellence in clinical care, teaching, and clinical, translational, and basic research. · - **Chief Purpose of this position**:The Children's Hospital ...
Emergency Medicine Full-Time position in Richmond, Virginia - Optum
Description
Primary Responsibilities:
Required Qualifications:
Preferred Qualifications:
