Massachusetts - Nurse Practitioner – (49019)
Duties & Responsibilities:
Main Duties and Responsibilities
Establish collaborative partnerships with Corner primary care providers.
Perform initial, semiannual, and unscheduled primary care assessments for shared participants as determined through communication with Corner primary care partners.
Conduct episodic visits as needed for shared participants at PACE Centers, facilities, or patient homes as determined through communication with Corner primary care partners.
Participate in weekly care-planning meetings with each of the three Upham’s PACE teams.
Other Duties and Responsibilities:
Obtain assessments performed by Corner primary care partners from EHR, share information in care-planning sessions with PACE teams, and upload to PACE EHR.
Share PACE care plans and care plan updates with Corner FQHC primary care partners.
Share assessments by PACE IDT members with Corner primary care partners as requested.
Conduct joint visits with Corner primary care partners as appropriate.
Collaborate with Upham’s Home Care nurses and Upham’s PACE home-based nurses in the care of homebound PACE community primary care patients.
Meet regularly with PACE Medical Director to review the implementation and operational performance of the PACE community primary care initiative.
Participate in PACE Quality program.
Participate in PACE Documentation & Coding program.
Attend monthly PACE primary care meetings.
Attend weekly FQHC meetings as appropriate.
Provide coverage for other PACE primary care providers as needed
J1 Visa: No
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