Job Description: Primary Responsibilities:Conduct comprehensive and follow-up patient assessments via a combination of in-home and virtual telehealth visits to include, but not limited to, Annual Wellness Visits (AWV) and Health Risk Assessments (HRA) in accordance with established guidelines set forth by Medicare, Medicaid, and commercial marketplace healthcare plans we serve.Commit to the practice of value-based care which emphasizes care in a home-based setting to improve and lower healthcare related costs, address and close gaps associated with population health leadership and drive high patient satisfaction.Conduct continued follow-up care of members to identify acute and chronic care diagnoses to be assessed in care management and active medical management.Works collaboratively with multi-disciplinary team members to develop and implement personalized treatment plans, including prescribing medications, therapies, and lifestyle modifications to promote a patient-centric care model.Deliver exemplary bedside manner with the ability to communicate complex medical information with simplicity and kindness to our members. Work in partnership with patients in the prevention of illness, promotion of health, and management of patient's adjustment to chronic health problems.Demonstrate proficiency and support use of the practice management system and electronic medical record (EMR).Abide by the ethics of the nursing/medical profession and all pertinent federal and state regulations and ordinances applicable to an individual’s scope of practice, including established HIPAA guidelines.Stay current with medical advancements, evidence-based practices, and professional development activities.Contribute to quality improvement initiatives, research projects, and educational programs as required.Other duties as assigned by the Clinical Operations Director and Supervising Physician. Key Qualifications Current, unrestricted NP or PA license to practice in state. Graduate of an accredited Physician Assistant program or Nurse Practitioner program required. Board Certification from ANCC or AANP (Nurse Practitioner) or NCCPA (Physician’s Assistant). Prescriptive authority/authorization in the State of state including the ability to obtain DEA controlled substance registration. Valid NPI and American Heart Association BLS Certification. Proven clinical experience as an Advanced Practice Provider, preferably in primary care, hospice, or urgent care/outpatient setting. Current state drivers' license, auto insurance and reliable transportation. Excellent administrative, organizational, and communication skills required. Commitment to ongoing professional development and staying abreast of the latest medical advancements. Compassionate and caring attitude with a desire to live our mission, vision and values. Preferred Qualifications Knowledge of HCC documentation, ICD-10 Coding, Health Risk Assessments, HEDIS, and STAR quality measures Bilingual proficiency in applicable areas Experience in care of older adult (geriatric) patients preferred Previous Medent EHR experience preferred