Housecall Providers https://www.housecallproviders.org/ Housecall Providers is a Portland area nonprofit organization and one of the largest providers of medical care exclusively in the home in the Western United States. We are proving every day that in home medical services for homebound and chronically ill patients can improve health outcomes, increase patient comfort, reduce health care costs and increase provider satisfaction. We are a proud part of the CareOregon family of health organizations. Our Mission Improving lives by bringing health care home. Our Vision To sustainably transform home-based medicine so all homebound adults and those living with serious illness have access to care that improves their quality of life. Our Values Compassion and respect, authentic relationships, collaboration, courage, social justice. Diversity Statement We embrace the diversity of our employees, patients, and those who care for them. Through awareness and advocacy, we are working to create health equity by recognizing and reducing barriers that affect non-dominant groups within Housecall Providers and our communities at large. The quadruple aim is real at Housecall Providers In home medical care for homebound patients is proven to increase patient comfort, improve health outcomes, reduce health care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ensuring greater patient comfort, improved health outcomes and care team satisfaction. With the population aging, more people are suffering from multiple chronic conditions and degenerative diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system. If you receive an offer of employment for this position, it is contingent on the satisfactory completion of a pre-employment background check, immunization review, and drug screen (including THC/Marijuana). CareOregon is a federal contractor and must comply with all federal laws. Job Title Nurse Practitioner - Hospice Department HCP-Hospice Exemption Status Exempt Requisition # 24629 Direct Reports N/A Manager Title Medical Director – Hospice Pay & Benefits Estimated hiring range $ 135,420 - $ 165,520 /year, 5% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits Posting Notes This hybrid role will split time between seeing patients in the Portland Metro area and working remotely from home. The schedule will be M, T, TH, F plus 1 weekend/month and 10 nights on call/month (0.8 FTE). The role will focus on face-to-face encounters to assess eligibility for services and symptom management with needed orders. Job Summary The Hospice Nurse Practitioner works in collaboration with hospice staff to provide professional, comprehensive, quality medical care with a focus on symptom palliation and end of life care to hospice patients under the direction of the supervising Housecall Providers Hospice Medical Director. Care may be provided directly, through visits to the patient’s place of residence/facility or indirectly by advising and directing members of the interdisciplinary team. This position also identifies opportunities to improve care delivery, uses resources effectively, and ensures compliance with legal, regulatory and clinical policies and procedures. Essential Responsibilities Clinical Services and Care + Collaborate with the interdisciplinary team to create, implement, and revise care plans which reflect the patient’s goals, values, and mental, spiritual, and physical needs to assure overall continuity of hospice services. + Assist in ensuring Housecall Providers hospice remains compliant with CMS guidelines by helping to complete face-to-face encounters in a timely fashion. + Document and share information to assist in determining initial and continuing eligibility of patients for hospice services. + Engage in independent decision making about a patient’s healthcare concerns and provide hospice services on an as needed basis; this may include managing urgent medical issues by advising and supporting on-call nursing staff, including after-hours and on weekends or making patient visits. + Provide education, counseling, and guidance to patients, families, and caregivers about medical issues, goals of care, and hospice services. + Help to coordinate case management activities for assigned patients. + Assess and counsel patients regarding hospice care needs; determine need for specialty and rehabilitative services and make appropriate referrals. + Document care provided in the patient’s clinical record, including evidence of end-stage-disease progression. + Review, prescribe and dispense medications and drugs to ensure adequate symptom management; initiate and/or continue medical regimes for new patients; review medication to ensure they are medically necessary. + Provide compassionate anticipatory guidance through decline due to chronic disease and provides high quality palliative care focused on the goals of the patient and family. + In conjunction with the hospice team, participate in family meetings to educate patients and families on medical conditions and the pros and cons of treatments or medications. + Manage complex clinical situations requiring a high level of responsibility, application of advanced subject knowledge, and significant independent judgment and initiative. + Deliver quality care while maintaining all company metrics pertaining to productivity. + Provide coverage for clinical colleagues in their absence. Administration + Participate in staff and professional conferences; consults on and assists in the development of in-service training and orientation activities in areas of treatment and care of the patient population; participate in peer review. + Assist in the development of policies and procedures. + Attend and participate in all required staff meetings and other ad hoc committees as assigned. + Participate in quality improvement activities as assigned. + Complete and maintain medical records according to agency protocols and in support of quality metrics. + As assigned by the Medical Director, may train and assess performance of other providers. + Participate in the development and updating of patient care policies and emergency procedures. + Participate in resolution of interpersonal conflict and issues of clinical and ethical concerns. + Maintain current knowledge of the latest research and trends in hospice care and pain/symptom management. Essential Department Functions + Propose, participate and implement process improvements. + Meet deadlines for completion of workload. + Practice in accordance with the nurse practitioner’s scope of practice and within established standards of care, and department policies, procedures, and guidelines. + Perform duties in compliance with Medicare Condition of Participation. + Develop and maintain professional boundaries with all patients/family/caregivers. + Serve as an ambassador for CareOregon and Housecall Providers at all times. + Demonstrate cooperation and teamwork and maintain collaborative relationships with all levels of staff and community partners. + Participate in ongoing education and assume responsibility for updating professional skills. + Maintain agreed upon work schedule. + Demonstrate cooperation and teamwork. + Provide cross-training on specific job responsibilities. + Meet identified business goals that contribute to departmental goals Organizational Responsibilities + Perform work in alignment with the organization’s mission, vision and values. + Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals. + Strive to meet annual business goals in support of the organization’s strategic goals. + Adhere to the organization’s policies, procedures and other relevant compliance needs. + Perform other duties as needed. Experience and/or Education Required + Master’s degree from an accredited advanced nurse practitioner program + Licensed nurse practitioner in the state of Oregon (ANCC or AANP certified) + Minimum one year of experience as a nurse practitioner + Drug Enforcement Administration (DEA) license + CPR (BLS) certification at hire or within 6 months in position + Valid driver’s license, acceptable driving record and automobile liability coverage or access to an insured vehicle Preferred + Certification in Hospice and Palliative Care (CHPN) + 2 years’ experience in geriatrics, safety net populations and/or hospice and palliative medicine + Experience in performing medical home visits + Experience with the mental health, substance abuse and behavioral health issues of a safety net population + Experience with medical ethics and quality improvement methodology Knowledge, Skills and Abilities Required Knowledge + Current clinical and regulatory knowledge regarding patient prognosis and hospice eligibility + Knowledge of the ethical and medico-legal aspects of medical practice + Knowledge of the principles and practices of public health, including familiarity with epidemiology, health services delivery and financing systems, and environmental health + Knowledge of the population served in adult health, including culture, demographics, patterns of disease, barriers to care and other unique features or special needs + Knowledge of available interventions and medications, the expected palliative benefits in the hospice population, and the likely ability to meet the needs of an individual patient + Knowledge of Federal, State and Local regulations, Hospice Medicare Conditions of Participation, and HIPAA privacy rules and regulations Skills and Abilities + Ability to assist in the development and implementation of appropriate outcome tools, metrics, and assessment strategies to inform quality outcome, safety, and performance improvement + Ability to understand the needs of and work with dying individuals in a hospice setting + Outstanding communications and conflict resolution skills; ability to provide emotional support to patients, caregivers and the hospice team + Ability to communicate effectively with diverse staff and patients, their families and caregivers + Problem-solving skills + Skilled in use of electronic medical records + Proficient in the practice of hospice and palliative care, particularly in a geriatric population + Cultural competence and ability to work effectively with people from all walks of life + Characteristics of compassion, commitment, and integrity that are required for success in this position + Ability to work a flexible schedule, including evenings and weekends + Ability to work both independently and collaboratively + Ability to work under pressure to meet deadlines + Ability to take initiative and utilize innovative techniques and ingenuity + Ability to plan, prioritize and coordinate multiple projects or tasks + The following cognitive or mental requirements are necessary on a daily basis: + Critical thinking + Reading, writing, mathematics + Drawing conclusions from written or computer-generated materials + Implementing recommendations by coordinating people and/or other resources + Developing plans, procedures, goals, strategies or processes + Clear verbal articulation + Ability to tolerate and manage stress and grief + Maintain effective professional boundaries for resiliency + Accept direction and feedback from manager and/or the leadership or hospice team + Ability to work effectively with diverse individuals and groups + Ability to learn, focus, understand, and evaluate information and determine appropriate actions + Ability to accept direction and feedback, as well as tolerate and manage stress + Ability to see, read, hear, speak clearly, sit, and perform repetitive finger and wrist movement for at least 6 hours/day + Ability to stand and/or bend for at least 3-6 hours/day + Ability to lift, carry, push, pull, crouch, crawl, reach, climb stairs, walk, and/or pinch small objects for at least 3 hours/day + Ability to operate a motor vehicle Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure Member/Patient Facing: ☐ No ☐ Telephonic ☒ In Person Hazards: May include, but not limited to, physical, ergonomic, and biological hazards. (Member Facing) Equipment: General office equipment and/or mobile technology Travel: Requires travel outside of the workplace at least weekly; the employee’s personal vehicle may be used. Driving infractions will be monitored in accordance with organizational policy. Work Location : Member/Patient Facing Setting Schedule : Ability to work a flexible schedule, including evenings and weekends. Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment. Veterans are strongly encouraged to apply. We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status. Visa sponsorship is not available at this time.