Recertification Manager Jobs in Bluffton, SC (NOW HIRING)

The Nurse Practitioner - PPV is responsible for modeling the Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation and for promoting the Compassus philosophy, using the 6 Pillars of Success as the foundation. S/he is responsible for upholding the Code of Ethical Conduct and for promoting positive working relationships within the company, among all departments, and all external stakeholders. The Nurse Practitioner, if providing palliative care, cares for patients facing chronic, complex, and/or life-threatening conditions at various locations within the flow of patient care. S/he provides assessments, disease and treatment education, and symptom management to meet the needs of palliative care patients and their families. The Nurse Practitioner helps the patient and family maintain their maximum level of comfort and coping. S/he provides care and support in collaboration with the PCP and specialists; and ensures compliance with practice standards and codes. S/he must collaborate appropriately with the assigned Compassus Medical Director. S/he must flex schedule to meet agency needs. The Nurse Practitioner, if providing hospice care, functions as an extension of the interdisciplinary team (IDT) and hospice physician to provide routine recertification and emergency assessments, educational, and evaluative services to meet the needs of patients and their families. S/he helps the patient and family maintain their maximum level of comfort and coping. S/he flexes schedule to meet agency visit needs and may be asked to provide after-hours emergency visits and/or admissions.

Position Specific Responsibilities

• If providing Hospice Care:
• Performs routine and emergency assessments:
• Completes routine and emergency recertification visits on each patient entering their 3rd benefit period or beyond (including admissions and transfers).
• Completes routine and emergency assessments on each patient as indicated by departmental policy.
• Records observations, treatments, and other pertinent information.
• Communicates with Medical Director, Attending Physician, DCS and IDT as directed regarding findings from the visits and any measures to alleviate symptoms.
• Provides physical and emotional care to support the patient and family in period of crisis.
• Prevents unwarranted hospitalizations by meeting patient and family needs in the home. In our programs that serve palliative care, the additional following outpatient responsibilities are needed:
• Performs routine and emergency assessments related to outpatient palliative care visits.
• Performs bedside palliative care patient/family evaluation in the patient's place of residence.
• Assists with diagnosis, treatment, and management of acute and chronic health conditions.
• Orders, performs, and interprets laboratory and radiology tests within scope of professional practice.
• Prescribes medications including controlled substances to the extent delegated and licensed.
• Orders treatments and durable medical equipment as indicated.
• Performs other therapeutic or corrective measures as indicated, including urgent care.
• Consults with palliative care physician or designees as needed, informs primary physician of services provided and collaborates with other physicians as needed.
• Assists in all facets of care coordination for palliative care referrals.
• Prepares and maintains accurate patient records, charts, and documents to support sound medical practice and reimbursement for services provided.
• Complies with applicable laws and regulations with respect to Collaborative Agreements.
• Initiates reimbursement for services rendered.
• Assists patients and families with goal setting related to treatment options and advanced care planning.
• Provides training and continuing education for staff.
• Assists in development of clinical practice guidelines/standards in support of quality palliative care.
• Adheres to the practice of confidentiality regarding patients, families, staff and the organization.
• Collaborates/Communicates with Medical Director, attending physician, DCS, and IDT:
• Collaborates/ Communicates with IDT needs of patient for clinical and psycho-social interventions.
• Assists in identifying the need for intervention of other IDT members.
• Effectively communicates patient and family needs to IDT.
• Completes and submits required paper work within 24 hours of visit completion.
• Educates patient and caregiver regarding:
• Care of patient.
• Disease process.
• Dying Process.
• Symptom control.
• Wound care.
• Performs other duties as assigned.
• If providing Hospice Face to Face Visits:
• Performs routine and emergency assessments:
• Completes routine and emergency recertification visits on each patient entering their 3rd benefit period or beyond (including admissions and transfers).
• Records observations, treatments, and other pertinent information.
• Communicates with Medical Director, Attending Physician, DCS and IDT as directed regarding findings from the visits and any measures to alleviate symptoms.
• Provides physical and emotional care to support the patient and family in period of crisis.
• Performs other duties as assigned.
• If providing Palliative Care:
• Performs routine and urgent assessments:
• Consistent communication of availability to manager.
• A minimum of 4 days of availability per month is required, however a minimum number of visits per month is not guaranteed to the PPV NP.
• Ability to triage consults by patient acuity.
• Performs bedside palliative care with patient/family education.
• Orders, performs, and interprets laboratory and radiology tests within scope of professional practice.
• Prescribes medications including controlled substances to the extent delegated and licensed.
• Orders treatments and durable medical equipment as indicated.
• Performs other therapeutic measures as indicated.
• Consults with palliative care physician or designees as needed, informs primary physician of services provided and collaborate with other physicians as needed.
• Assists in all facets of care coordination for palliative care referrals.
• Prepares and maintains accurate patient records, charts, and documents to support sound medical practice and reimbursement for services provided.
• Complies with applicable laws and regulations with respect to Collaborative Agreements.
• Completes accurate billing and coding activities for all patient encounters according to CMS guidelines.
• Defines goals for professional growth and participates actively in professional activities and organizations.
• Engages in active and frequent self-care activities for personal and professional growth and longevity.
• Adheres to the practice of confidentiality regarding patients, families, staff and the Organization.
• Assists patients and families in identification of goals of treatment and ongoing plans of care at every visit. Communicates these goals among Interdisciplinary Team (IDT).
• Collaborates/Communicates with Medical Director, attending Physician, hospital staff and IDT:
• Participates in monthly IDT meeting with market team.
• Collaborates/ Communicates with IDT needs of patient for clinical and psycho-social interventions.
• Assists in identifying the need for intervention of other IDT members.
• Effectively communicates patient and family needs to IDT.
• Completes and submits required clinical documentation within 24 hours of visit completion.
• Educates patient and caregiver regarding:
• Care of patient.
• Disease process.
• Goal setting.
• Symptom control.
• Treatment options.
• Prognosis.
• Advance Care Planning.
• Supervises nurse trainees, including graduate and advance practice nurses in field placements.
• Participates in supervision of other trainees, including medical students, residents, fellows, and social work and psychology trainees.
• Performs other duties as assigned.

Education and/or Experience

• Master's degree in Nursing required.
• If providing Hospice Care: Minimum of one (1) year nursing practice or equivalent experience required; hospice, oncology, or home health and/or long-term care preferred.
• If providing Palliative Care: Minimum of five (5) years nursing experience required; clinical nursing care in oncology, hospice, geriatrics, intensive care preferred.

Skills