Top 30 Nurse practitioner home risk assessment Jobs in Maryland

CTO Lead Care Manager RN
MedStar Health —Baltimore, MD
- $89,065 - $162,801 a year
- Full-time
- Microsoft Word
- Nursing
- Microsoft Excel
FULLY LICENSED THERAPIST (LCPC / LCSW-C)
Nurse Practitioner On Call LLC —Baltimore, MD
- Part-time
- Remote
- HIPAA
- Mid-level
- Master's degree
- Work from home
- Flexible schedule
Quick Apply
Nurse Practitioner (Per Diem)
ComplexCare Solutions —Dundalk, MD
- $2,400 - $10,000 a month
- Per diem
- Bilingual
- CPR Certification
- Nursing
- 401(k)
Quick Apply
Nurse Practitioner (Full Time) Regional Traveler - In-Home Health Assessments
Matrix Medical Network —Windsor Mill, MD
- $134,100 - $149,700 a year
- Weekends as needed
- Hybrid work
- CPR Certification
- Nursing
- Skilled nursing facility
- Mileage reimbursement
- Paid holidays
Quick Apply
FULLY LICENSED THERAPIST - LCPC LCSW-C
NURSE PRACTITIONER ON CALL LLC —Baltimore, MD
- $70 - $100 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- Master's degree
- Work from home
- Employee discount
Quick Apply
Registered Nurse - Partial Hospitalization Program
Signet Health Corporation —Clinton, MD
- $40 - $45 an hour
- Part-time
- Nursing
- RN License
- Hospital
14d
Nurse Practitioner or Physician Assistant - Senior Care - Chevy Chase, Potomac, Rockville, MD - Optum
Optum —Chevy Chase, MD
- $109,500 - $164,000 a year
- Full-time
- Vital signs
- Pass drug screening
- Mid-level
- Loan repayment program
Quick Apply
5d
Nurse Practitioner (Salisbury, MD)
Porter Cares, Inc. —Salisbury, MD
- $100 an hour
- Vital signs
- Mid-level
- Home health
- Flexible schedule
Quick Apply
Value Based Care Practitioner
Chase Brexton Health Care —Baltimore, MD
- $115,202.50 - $140,000.00 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Medical Manager
CarePoint Response —Baltimore, MD
- $100,000 - $130,000 a year
- Full-time
- Nursing
- Medicine
- Psychiatry
- Disability insurance
- Health insurance
Licensed Marriage and Family Therapist
Enterprise Mangement Solutions Inc —Baltimore, MD
- $50,040 a year
- Part-time
- Background check
- LMFT
- Writing skills
Social Worker (Clinical Coordinator)
Interim HealthCare of Annapolis, MD —Annapolis, MD
- $60,000 - $65,000 a year
- Full-time
- Background check
- Management
- Writing skills
Quick Apply
Medical Manager (11306)
Baltimore Crisis Response Inc —Baltimore, MD
- $100,000 - $130,000 a year
- Full-time
- Nursing
- Medicine
- Psychiatry
- Disability insurance
- Health insurance
Staff Physician- Gastroenterology
US Veterans Health Administration —Baltimore, MD
- $350,000 - $400,000 a year
- Part-time
- Background check
- Medicine
- Management
- Paid holidays
- Dental insurance
Physician Family Medicine
Greater Baden Medical Services, Inc. —Capitol Heights, MD
- CPR Certification
- Medicine
- BLS Certification
Quick Apply
CRNA Implementation (Travel) Team Maryland
North American Partners in Anesthesia —Cumberland, MD
- $0.58 per mile
- Full-time
- Nursing
- RN License
- Travel
- Profit sharing
- Health savings account
Psychiatric Mental Health Nurse Practitioner 5
Enterprise Mangement Solutions Inc —Baltimore, MD
- $45 - $100 an hour
- Part-time
- Nursing
- Doctoral degree
- Psychiatry
- Disability insurance
- Health insurance
Advanced Practice Provider, Primary Care Provider
AbsoluteCare —Greenbelt, MD
- $150,000 - $160,000 a year
- Full-time
- Background check
- Primary Care
- ACLS Certification
- Health insurance
- Dental insurance
Quick Apply
Pediatrician
Greater Baden Medical Services, Inc. —Capitol Heights, MD
- Full-time
- CPR Certification
- Medicine
- BC/BE
Quick Apply
Family Medicine Physician w/OB
Greater Baden Medical Services, Inc. —Lexington Park, MD
- CPR Certification
- Medicine
- BLS Certification
Quick Apply

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CTO Lead Care Manager RN

MedStar Health -
Baltimore, MD

Apply Now

Job Details

Full-time
$89,065 - $162,801 a year

Qualifications

RN License
Data summary reports
Driver's License
Managing projects
Associate's degree
Associate Degree in Nursing

Full Job Description

About this Job:

General Summary of Position
The RN CTO Lead Care Manager serves as a member of the interdisciplinary care management team capable of furnishing an array of care coordination services to Medicare FFS beneficiaries, attributed to practices that the Care Transformation Organization (CTO) supports.

This position is Monday through Friday, 8 am- 4:30 pm, and covers the Silver Spring office, with potential coverage at MedStar Health Primary Care at Chevy Chase.

Responsible for the care management and care coordination of Medicare beneficiaries attributed to a medical practice(s); Serves as the liaison between the medical practice and the CTO's interdisciplinary care team.

Primary Duties and Responsibilities

Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
In collaboration with the interdisciplinary care team acts as primary care team agent for the coordination of care for a panel of attributed Medicare beneficiaries by ensuring the following: Ensures attributed beneficiaries have timely access to care (same day or next day access to the patient's own practitioner and/or care team for urgent care or transition management); Facilitates use of alternatives for care outside of the traditional office visit to increase access to the care team and the practitioner such as e-visits phone visits group visits home visits and visits in alternate locations (senior centers assisted living) captured in the medical record; Assists patients with scheduling appointments with providers including annual wellness visits.
Attributed beneficiaries receive a follow up interaction from the practice within 2 days for hospital discharge and within one week for Emergency Department (ED) discharges; Coordinates referral management for attributed beneficiaries seeking care from high-volume and/or high-cost specialists as well as EDs and hospitals; Facilitates connection to services for patients who may benefit from behavioral health services including: patients with serious mental illness patients with substance use disorders' patients with depression anxiety or other mental health conditions patients with behavioral and social risk factors and BH issues patients with multiple co-morbidities and BH issues; Assists with identifying patients to participate in the Patient-Family/ Caregiver Advisory Council (PFAC) and help to organize and facilitate the PFAC annual meetings; Engages attributed beneficiaries and caregivers in a collaborative process for advance care planning (MOLST Advanced Directives Proxy).
Under the direction of the practice physician may perform direct patient care including wellness visits transitional care administer vaccinations screenings etc.
Assesses plans implements monitors and evaluates options and services to meet health needs of attributed beneficiaries. Manages a caseload in compliance with contractual obligations and the MD Primary Care Program (MDPCP) standards.
Conducts comprehensive member assessments through root cause analysis based on member's needs and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs.
Monitors and evaluates effectiveness of care plan and modifies plan as needed. Supports member access to appropriate quality and cost-effective care. Coordinates with internal and external resources to meet identified needs of the member's care plan and collaborates with providers.
Acts as a liaison and member advocate between the member/family physician and facilities/agencies. Provides clinical consultation to physicians professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations.
Interacts continuously with members family physician(s) and other resources to determine appropriate behavioral action needed to address medical needs. Reviews benefits options researches community resources trains/creates behavioral routines and enables members to be active participants in their own healthcare.
Ensures members are engaging with their PCP to complete their care management treatment plan or preventive care services.
Ensures daily telephonic patient communication to help to close gaps in care and provide up-to-date healthcare information helping to facilitate the members understanding of his/her health status using available reports including quality m page and HIE CRISP to ensure relevant medical history/encounter are accessible in EMR.
Facilitates ongoing communication amongst practice and care team by participating in huddles hosting regular conference calls in-person meetings or coordinating regular email updates to ensure alignment of activity discuss new developments and exchange information.
Performs analysis of attributed beneficiary data and presents data intelligently and creatively in a way that can be easily and quickly grasped by the practice and interdisciplinary care team as appropriate.
Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.
Performs other duties as assigned.

Minimal Qualifications
Education

Associate's degree in Nursing (ADN) required and
Bachelor's degree in Nursing (BSN) preferred

Experience

3-4 years Work experience including 1 or more years of proven case management experience. Familiarity with the local area and/or population health workforce integration. required and
Experience with data collection and reporting; community outreach experienceexperience working in an ambulatory setting preferred

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure Registered Nurse licensed in the State of Maryland Upon Hire required and
CCM - Certified Case Manager from a nationally recognized certification agency within 1-1/2 Yrs preferred and
DL NUMBER - Driver License Valid and in State (DRLIC) Upon Hire required

Knowledge Skills and Abilities

Effective verbal and written communication skills.
Excellent interpersonal and customer service skills especially serving geriatric patients.
Strong analytical and critical thinking skills.
Strong community engagement and facilitation skills.
Advanced project management skills.
Commitment to collective impact concepts.
Flexibility and the ability to work autonomously as well as take direction as needed.
Cultural competency.
Proficient computer skills along with experience using Microsoft applications-Word Excel etc. and familiarity with entering data in an electronic medical record (EMR).

This position has a hiring range of : USD $89,065.00 - USD $162,801.00 /Yr.

Apply Now

Refine Your Search

nurse practitioner home risk assessment jobs in maryland

CTO Lead Care Manager RN

FULLY LICENSED THERAPIST (LCPC / LCSW-C)

Nurse Practitioner (Per Diem)

Nurse Practitioner (Full Time) Regional Traveler - In-Home Health Assessments

FULLY LICENSED THERAPIST - LCPC LCSW-C

Registered Nurse - Partial Hospitalization Program

Nurse Practitioner or Physician Assistant - Senior Care - Chevy Chase, Potomac, Rockville, MD - Optum

Nurse Practitioner (Salisbury, MD)

Value Based Care Practitioner

Medical Manager

Licensed Marriage and Family Therapist

Social Worker (Clinical Coordinator)

Medical Manager (11306)

Staff Physician- Gastroenterology

Physician Family Medicine

CRNA Implementation (Travel) Team Maryland

Psychiatric Mental Health Nurse Practitioner 5

Advanced Practice Provider, Primary Care Provider

Pediatrician

Family Medicine Physician w/OB

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