Job Description

ComplexCare Solutions (CCS) specializes in helping those in need by delivering high value in-home and virtual assessments for health plans nationwide. We pride ourselves on our member engagement aimed towards evaluating current health status, gaps in care, potential health risks and care management opportunities with a focus on driving better clinical outcomes. Our visits give Providers the opportunity to spend a full hour with these members which allows them to capture a comprehensive picture of that individual’s personal needs and what is required to keep them in the home and out of the hospital.

CCS is calling on Nurse Practitioners that are passionate about helping their local communities. We care dearly about those we serve and we need your help to make a difference in the lives of our members.

Pay Range:

In-Home Assessment: $120

Telehealth Assessment: $100

• Perform in-home annual health assessment of high-risk health plan members leading to comprehensive picture of a member’s medical conditions, prior and current medical history, as well as conduct a medication review.
• Provide member education regarding health conditions, medications, and nutrition. Emphasize the importance of consistent monitoring of health needs together with their Primary Care Physician.
• Identify opportunities for preventive care, health promotion, home safety, and illness prevention.
• Complete all documentation within 24 hours from visit.
• Communicate urgent medical needs (including all prescription needs) with the member’s Primary Care Physician. CCS Nurse Practitioners are not permitted to prescribe medication per CCS policy.
• Document clinical escalations, i.e., urgent medical or non-urgent care management needs, in accordance CCS policy.
• Communicate clearly and in a timely manner with manager when clinical escalations are encountered.
• Perform, document, and communicate results of in-home Point of Care (POC) Testing when directed.
• Be responsive to CCS managers and directives (policies) and comply with trainings and updates as mandated by CCS.
• Maintain ongoing Continuing Education as mandated by state licensure. Maintain strong professional level of knowledge and comprehensive clinical assessment skills related to chronic disease documentation including the following:
  • Knowledge of CMS Regulations and NCQA HEDIS Guidelines;
  • Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)
  • Familiarity with ICD-10 and CPT coding practices.

• Active un-encumbered license to practice nursing;
• Nurse Practitioner Certification from either the ANCC or AANP; in Family, Adult, Gerontology or Emergency Medicine.
• Board Certified through the AANP or ANCC
• Maintains current CPR certification
• Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing:
• Hepatitis B
• Influenza
• MMR: Measles, Mumps and Rubella
• Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap)
• Varicella
• Tuberculosis
• Home Health exp a plus
• Must be able to effectively communicate with elderly and chronically ill patients and families;
• Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial;
• Ability to multitask;
• Excellent customer service skills;
• Bi-lingual or multi-lingual a plus.

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