Top 4 Nurse practitioner evercare program Jobs in Kalamazoo Mi

Registered Nurse - EverCare Program
Hospice of Michigan - EverCare Program —Kalamazoo, MI
- Full-time
- Nursing
- RN License
- Adults
- 403(b) matching
- Paid parental leave
Quick Apply
Nurse Practitioner - EverCare Program
Hospice of Michigan - EverCare Program —Kalamazoo, MI
- Full-time
- Nursing
- Skilled nursing facility
- Doctoral degree
- 403(b) matching
- Paid parental leave
Quick Apply
EverCare Nurse Practitioner
Hospice of Michigan —Kalamazoo, MI
- Full-time
- Nursing
- Skilled nursing facility
- Doctoral degree
Quick Apply
EverCare Registered Nurse
Hospice of Michigan —Kalamazoo, MI
- Full-time
- Nursing
- RN License
- Adults
Quick Apply

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Registered Nurse - EverCare Program

Hospice of Michigan - EverCare Program -
Kalamazoo, MI

Quick Apply

Job Details

Full-time

Benefits

403(b) matching
Paid parental leave
Health savings account
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Paid time off
Parental leave
Vision insurance
403(b)
Life insurance
Pet insurance

Qualifications

Nursing
RN License

Full Job Description

Help Build Something New!

Join Hospice of Michigan – EverCare Practice and play a key role in launching and growing an innovative geriatric primary care program. This is a unique opportunity to help shape a brand-new care model while making a meaningful difference in the lives of older adults.

We're seeking a compassionate Registered Nurse who is passionate about providing exceptional, patient-centered care. If you have experience in primary care, home care, geriatrics, care management, or assisted living, we'd love to hear from you.

All full-time and eligible part-time employees would have the following benefits:

Health, Dental, and Vision insurance
Paid parental leave
Flexible spending account
Health savings account
Life insurance Tuition reimbursement
Pet insurance
Generous paid time off
403(b) retirement savings with company match

What You'll Do

Serve as the primary RN care manager for a panel of medically complex older adults.
Coordinate chronic disease management and care transitions to improve patient outcomes.
Partner closely with Nurse Practitioners, physicians, and the interdisciplinary team to deliver proactive, value-based care.
Delivers Chronic Care Management (CCM), Complex Chronic Care Management, and Principal Care Management (PCM) services in accordance with Medicare requirements, including obtaining and documenting patient consent, developing and maintaining comprehensive electronic care plans, and accurately tracking and documenting time to support billing of CCM/PCM codes.
Develops, implements, and continuously updates a comprehensive, patient-centered care plan for each enrolled patient that addresses all chronic conditions, functional status, cognitive status, psychosocial needs, medications, preventive services, and patient/caregiver goals of care.
Conducts scheduled telephonic and telehealth outreach to enrolled patients between provider encounters to assess symptoms, monitor disease control, reinforce the treatment plan, and identify early signs of clinical deterioration.
Performs medication reconciliation and adherence assessments at every care management contact and following all transitions of care; identifies polypharmacy risks and potentially inappropriate medications in older adults and escalates findings to the Nurse Practitioner or collaborating physician.
Supports Transitional Care Management (TCM) by tracking hospital admissions, emergency department visits, and skilled nursing facility stays for the panel; completes interactive contact within two business days of discharge; reconciles discharge medications and ensures timely post-discharge follow-up visits are scheduled to reduce avoidable readmissions.
Prepares for and supports Annual Wellness Visits (AWVs), including completion of health risk assessments, screenings (cognitive, fall risk, depression, functional status), and preventive care planning in collaboration with the Nurse Practitioner.

Qualifications

Current Michigan Registered Nurse (RN) license.
Minimum of 3 years of clinical nursing experience.
Experience in primary care, home care, geriatric care, care management, chronic disease management, or assisted living is strongly preferred.

Work Location: In person

Quick Apply

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nurse practitioner evercare program jobs in kalamazoo mi

Registered Nurse - EverCare Program

Nurse Practitioner - EverCare Program

EverCare Nurse Practitioner

EverCare Registered Nurse

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