APP - Care Management
Apply NowCompany: JPS Health Network
Location: Fort Worth, TX 76137
Description:
Acclaim Multi-Specialty Group, Inc. (Acclaim) is a multi specialty medical group practice comprised of over 500 physicians, nurse practitioners, and physician assistants that partner with JPS Health Network (JPS). Acclaim supports JPS's mission of transforming healthcare delivery for the communities we serve. From primary care to pediatrics to a full range of specialties, Acclaim's goal is to provide high-quality, compassionate care for every patient, every time.
As the county health network and Level-1 Trauma Center, JPS has been serving the residents of Tarrant County for over 100 years. In addition to providing high-quality care, JPS is also an urban teaching hospital with a long history of training physicians and medical students. JPS offers 18 residency and fellowship programs, including the largest family medicine residency in the nation. JPS educates in tandem with the University of North Texas Health Science Center, Texas College of Osteopathic Medicine, and Texas Christian University Medical School.
For more information, visit www.teamacclaim.org.
Job Title:
APP - Care Management
Requisition Number:
req24052
Location:
Acclaim Magnolia
Job Description:
Job Summary:
An Advanced Practice Provider (APP) for care management is responsible for providing and coordinating care of patients with chronic medical conditions. The APP works closely with physicians, nurses, and other healthcare professionals to develop comprehensive care plans that address the individual needs of each patient. The APP conducts initial assessments, develops treatment goals, monitors progress, and provides ongoing support to help patients manage their conditions effectively. The APP also educates patients on self-management strategies, medication management, and lifestyle modifications to improve their overall health outcomes. The APP plays a key role in promoting continuity of care, improving patient satisfaction, and preventing hospital readmissions for patients with chronic conditions.
Duties and Essential Job Functions:
Conduct initial assessments of patients with chronic conditions to determine their healthcare needs and develop individualized care plans.
Conduct post-hospital follow-up care within 7 days of discharge for improved management of care.
Conduct Medicare Annual Wellness Visits.
Collaborate with physicians, nurses, pharmacists, and other healthcare professionals to coordinate and implement patient care.
Facilitate communication between healthcare providers to ensure seamless transitions of care.
Coordinate services, referrals, and resources to optimize patient outcomes.
Monitor and evaluate patients' progress in managing their chronic conditions across various settings, including hospitals, clinics, and community resources, adjusting treatment plans as needed.
Specialize in the comprehensive management of chronic conditions, offering education and support to patients for self-management.
Adhere to evidence-based guidelines for the effective treatment and monitoring of diseases.
Educate patients on their conditions, medications, treatment options, and lifestyle modifications to promote self-management.
Provide counseling and support to help patients cope with the challenges of living with chronic illnesses.
Connect patients with community resources, support groups, and other services to enhance their overall well-being.
Document patient assessments, interventions, and outcomes in electronic health records accurately and timely.
Utilize data to identify trends, gaps in care, and areas for improvement.
Participate in quality improvement initiatives to enhance the quality and effectiveness of chronic care management services.
Participate in emergency response protocols as needed, providing immediate care and coordination during crises.
Stay current on evidence-based practices, guidelines, and emerging trends in chronic disease management.
Maintain professional certifications, licenses, and continuing education requirements to ensure competency in providing optimal patient care.
And perform other duties as assigned.
Qualifications:
Required Education and Experience:
Master's Degree in Nursing from an accredited school of nursing
OR
Graduate of an accredited Physician Assistant Program
AND
Minimum 2 years of clinical experience.
Required Licensure/Certification/Specialized Training:
Current state licensure as a Nurse Practitioner or Physician Assistant.
Basic Life Support (BLS) certification.
Preferred Education and Experience:
Clinical experience as an APP with a focus on care coordination and chronic disease management.
Certification in Geriatrics.
Preferred Licensure/Certification/Specialized Training:
Certification in Care Management (e.g., ACM, CCM)
Knowledge, Skills & Abilities:
Knowledge of advanced techniques and care management within specialty area.
Knowledge and understanding of customer service principles.
Knowledge of safety and security principles.
Knowledge of HIPAA regulations.
Skill in solving mathematic computations needed to accurately calculate medication dosages and assist with reports and collection and analysis of data.
Skilled in analyzing data, drawing conclusions, and making recommendations.
Time management skills.
Ability to collaborate with referring physicians, residents, clinical staff and support staff to provide quality patient care.
Ability to present information or ideas concisely, accurately, and clearly verbally and in writing.
Ability to delegate tasks appropriately, with consideration for educational level, age and developmental stage of employee.
Ability to work well under pressure.
Ability to demonstrate patient centered and patient valued behavior.
Ability to work effectively in a matrix environment.
Ability to work in a fast-paced environment that requires results.
Ability to maintain a positive and effective working relationship with coworkers, patients, and visitors
Physical Requirements:Prolonged standing, sitting, walking, reading, writing, talking, use of computer
Hearing ability for verbal communication via telephone systems, and person - to -person and to perform assessments such as obtaining blood pressure, cardiac or breathe sounds.
Clear concise speaking ability to provide information and instruction.
Visual acuity to read information from computer screens, forms and other printed materials and information.
Manual and tactile dexterity for palpation, use of computer keyboard/typing, writing, handling/ sorting objects and forms.
Flexibility and body movement for bending, crouching, walking, kneeling, standing, reaching, lifting and moving objects and equipment (approximately 25lbs. or more with assistance), sitting.
Able to meet physical demands of the job with assistive or adaptive devices or reasonable accommodations.
Work Environment:
Work is indoors and may be subject to schedule changes and/or variable work hours, and /or overtime hours, and/or occasional weekend hours on short notice.
Exposure to environment temperature changes, hazardous/noxious fumes, fetid smells, air/blood borne pathogens such as HIV, Hepatitis B, TB, and other contagious diseases.
Environment is noisy, involves frequent interruptions or distractions.
Duties subject to stressful pressures and deadlines.
Wearing of uniform or a specific style/type of clothing and jewelry/accessories limitations or restriction may be required.
Location Address:
200 W. Magnolia
Fort Worth, Texas, 76104
United States
As the county health network and Level-1 Trauma Center, JPS has been serving the residents of Tarrant County for over 100 years. In addition to providing high-quality care, JPS is also an urban teaching hospital with a long history of training physicians and medical students. JPS offers 18 residency and fellowship programs, including the largest family medicine residency in the nation. JPS educates in tandem with the University of North Texas Health Science Center, Texas College of Osteopathic Medicine, and Texas Christian University Medical School.
For more information, visit www.teamacclaim.org.
Job Title:
APP - Care Management
Requisition Number:
req24052
Location:
Acclaim Magnolia
Job Description:
Job Summary:
An Advanced Practice Provider (APP) for care management is responsible for providing and coordinating care of patients with chronic medical conditions. The APP works closely with physicians, nurses, and other healthcare professionals to develop comprehensive care plans that address the individual needs of each patient. The APP conducts initial assessments, develops treatment goals, monitors progress, and provides ongoing support to help patients manage their conditions effectively. The APP also educates patients on self-management strategies, medication management, and lifestyle modifications to improve their overall health outcomes. The APP plays a key role in promoting continuity of care, improving patient satisfaction, and preventing hospital readmissions for patients with chronic conditions.
Duties and Essential Job Functions:
Conduct initial assessments of patients with chronic conditions to determine their healthcare needs and develop individualized care plans.
Conduct post-hospital follow-up care within 7 days of discharge for improved management of care.
Conduct Medicare Annual Wellness Visits.
Collaborate with physicians, nurses, pharmacists, and other healthcare professionals to coordinate and implement patient care.
Facilitate communication between healthcare providers to ensure seamless transitions of care.
Coordinate services, referrals, and resources to optimize patient outcomes.
Monitor and evaluate patients' progress in managing their chronic conditions across various settings, including hospitals, clinics, and community resources, adjusting treatment plans as needed.
Specialize in the comprehensive management of chronic conditions, offering education and support to patients for self-management.
Adhere to evidence-based guidelines for the effective treatment and monitoring of diseases.
Educate patients on their conditions, medications, treatment options, and lifestyle modifications to promote self-management.
Provide counseling and support to help patients cope with the challenges of living with chronic illnesses.
Connect patients with community resources, support groups, and other services to enhance their overall well-being.
Document patient assessments, interventions, and outcomes in electronic health records accurately and timely.
Utilize data to identify trends, gaps in care, and areas for improvement.
Participate in quality improvement initiatives to enhance the quality and effectiveness of chronic care management services.
Participate in emergency response protocols as needed, providing immediate care and coordination during crises.
Stay current on evidence-based practices, guidelines, and emerging trends in chronic disease management.
Maintain professional certifications, licenses, and continuing education requirements to ensure competency in providing optimal patient care.
And perform other duties as assigned.
Qualifications:
Required Education and Experience:
Master's Degree in Nursing from an accredited school of nursing
OR
Graduate of an accredited Physician Assistant Program
AND
Minimum 2 years of clinical experience.
Required Licensure/Certification/Specialized Training:
Current state licensure as a Nurse Practitioner or Physician Assistant.
Basic Life Support (BLS) certification.
Preferred Education and Experience:
Clinical experience as an APP with a focus on care coordination and chronic disease management.
Certification in Geriatrics.
Preferred Licensure/Certification/Specialized Training:
Certification in Care Management (e.g., ACM, CCM)
Knowledge, Skills & Abilities:
Knowledge of advanced techniques and care management within specialty area.
Knowledge and understanding of customer service principles.
Knowledge of safety and security principles.
Knowledge of HIPAA regulations.
Skill in solving mathematic computations needed to accurately calculate medication dosages and assist with reports and collection and analysis of data.
Skilled in analyzing data, drawing conclusions, and making recommendations.
Time management skills.
Ability to collaborate with referring physicians, residents, clinical staff and support staff to provide quality patient care.
Ability to present information or ideas concisely, accurately, and clearly verbally and in writing.
Ability to delegate tasks appropriately, with consideration for educational level, age and developmental stage of employee.
Ability to work well under pressure.
Ability to demonstrate patient centered and patient valued behavior.
Ability to work effectively in a matrix environment.
Ability to work in a fast-paced environment that requires results.
Ability to maintain a positive and effective working relationship with coworkers, patients, and visitors
Physical Requirements:Prolonged standing, sitting, walking, reading, writing, talking, use of computer
Hearing ability for verbal communication via telephone systems, and person - to -person and to perform assessments such as obtaining blood pressure, cardiac or breathe sounds.
Clear concise speaking ability to provide information and instruction.
Visual acuity to read information from computer screens, forms and other printed materials and information.
Manual and tactile dexterity for palpation, use of computer keyboard/typing, writing, handling/ sorting objects and forms.
Flexibility and body movement for bending, crouching, walking, kneeling, standing, reaching, lifting and moving objects and equipment (approximately 25lbs. or more with assistance), sitting.
Able to meet physical demands of the job with assistive or adaptive devices or reasonable accommodations.
Work Environment:
Work is indoors and may be subject to schedule changes and/or variable work hours, and /or overtime hours, and/or occasional weekend hours on short notice.
Exposure to environment temperature changes, hazardous/noxious fumes, fetid smells, air/blood borne pathogens such as HIV, Hepatitis B, TB, and other contagious diseases.
Environment is noisy, involves frequent interruptions or distractions.
Duties subject to stressful pressures and deadlines.
Wearing of uniform or a specific style/type of clothing and jewelry/accessories limitations or restriction may be required.
Location Address:
200 W. Magnolia
Fort Worth, Texas, 76104
United States