Primary Responsibilities

The NP is responsible for practicing the nursing profession ethically, dutifully, and according to and within the Scope and Standards of Practice of the Texas Board of Nursing. The NP is responsible for Provider-level care coordination, as outlined in the Texas Independence Health Plan (ISNP) Model of Care, for all ISNP Members.

 

The NP is generally expected to be in his/her facilities during customary working hours (approximately 8:00am – 5:00pm) to ensure that these facilities have adequate Provider-Level  coverage to meet patient/resident/member health care needs while also allowing the NP to have adequate time for documentation, and rotational weekday/weekend on-call responsibility.

Essential Functions

 

Responsible for maintaining a high measure of professionalism in dress and actions that appropriately reflect the mission and policies of the organization and facilities with whom they work and within which they work. Attend and participate in daily morning meetings daily when in facilities. Accountable for their own clinical and professional actions and to performing duties within the appropriate scope of practice allowed by respective prescriptive authority agreements with attending physicians. Respond timely to all Compliance requests. Report to the Clinical Operations Manager (COM), maintain communication with COM and facility staff regarding Plan specific to facility and/or patient/family concerns. Responsible for Provider-Level health care delivery and preventative care management for specific Texas Independence Health Plan ISNP Plan Members (Plan Members) who are assigned to collaborating physicians in assigned practice facilities. Provide proactive, preventative/maintenance care for the Plan Members’ medical, emotional, and behavioral conditions. Provide clinical care and education to Plan Members, as well as education to the family and Nursing Facility staff. Adhere to and be accountable to all ISNP Model of Care Provider metrics and goals. Participate in an on-call rotation to ensure continuity of care for Plan Members after hours, weekends and holidays. Maintain reasonable and appropriate communication with the facility staff for questions, notifications, and family concerns to assist in providing optimal clinical care. Efficiently navigate and operate a laptop computer and enter data and documentation daily into designated Electronic Medical Record Systems in a timely manner. Participate in ongoing staff education and reasonably assist, as requested, with Quality Improvement at the facilities/communities. Communicate professionally in face to face conversations with families and staff. Review medications, orders, and diagnostic tests, and respond to abnormalities appropriately, within BON approved scope of practice. Provide ongoing evaluation and treatment options of chronic illnesses, and care for acute exacerbations of chronic illnesses as they occur. Provide ongoing evaluation and education to patients and families on Advance Care Planning (Goals of Care and Anticipatory planning). Review and respond to consultant recommendations such as psychiatric, dietary, rehabilitative therapies, and pharmacy. Perform all other duties congruent with the ISNP Plan as assigned. Maintain adequate Medical Malpractice Insurance (generally expected to be $1m/$3m).