Nurse Practitioner Clinical Lead

Job Summary:    Assumes responsibility and accountability for the Nurse Practitioner (NP) Clinical Lead role within the NorthStar Care Community (NSCC) as detailed below. The NP Clinical Lead dedicates approximately 80% of time to the delivery of direct hospice and/or palliative patient care, performing all essential functions of the NP role, and approximately 20% of time to administrative and clinical leadership responsibilities in support of the NPs within the assigned region(s). Provides services under a collaborative practice agreement with the physicians of the practice. Participates in the on-call schedule per on-call policy.

This role may include some or all of the below essential functions for hospice and/or palliative care based on assignments. The essential functions for the Clinical Lead (Administrative) role apply to all NP Clinical Lead assignments.

 

Essential Functions for Hospice NP Role:

• Completes and documents an accurate history and physical examination and documents findings for Face to Face and/or certification of terminal Illness for physician review of initial and ongoing hospice eligibility.
• In collaboration with the hospice and attending physicians, works to establish and meet the goals of care, coordinates with internal and external members of the patient’s health care and family/caregiver teams, and makes recommendations for identified immediate needs and ongoing treatment plans.
• Completes timely and accurate documentation of all activities in the electronic medical record (EMR).
• Provides assistance to patients/families in goal setting, care plan development and end-of-life discussions.
• Promotes access to community resources and acts as a liaison by relaying information to other health care professionals and agencies to provide for continuity of care.
• Participates in Quality Assurance activities and committee service related to NP scope of practice and policies/procedures.
• Maintains consistent and on-going communications with attending physician regarding all aspects of care.
• Promotes patient relations through confidentiality, privacy, and dignity.  Provides services in a quick and courteous manner with care and respect for the patient’s individual needs. 
• Consults with physicians within the practice according to the collaborative practice agreement.
• Communicates with nursing home and other facility staff regarding goals and treatment plans.
• Provides educational support to the orientation process, ongoing staff development, and education about the organization’s services to referral sources, facilities, and the community.
• Maintains oversight of all allocated resources within assigned areas of responsibility including but not limited to time, expenses, supplies and labor and ensures pre-determined financial margins and/or clinical outcomes are achieved.
• Provides support to physicians as needed, including attending IDT with physician when requested.
• Acts as a representative of the NorthStar Community in the facilities, homes, and communities of the patients we serve. This includes identifying and solving problems within the NP scope of practice and patient care plan that are being encountered as part of the care delivered.

Essential Functions for Palliative NP Role:

• Completes an accurate history and physical examination and provides diagnosis and treatment of symptoms, including recommending or prescribing of medications and treatments (as preferred by referring provider) according to the collaborative agreement and NP scope of practice laws and as approved by the Director of Medical Affairs.
• Working with the collaborating physician, identifies and documents medical necessity for home/facility encounters, including appropriateness for initiating services, timing/necessity of follow up encounters, and appropriateness for hospice evaluation and/or discharge from practice.
• Works to establish and meet the goals of care, coordinates with internal and external members of the patient’s health care and family/caregiver teams, and coordinates referral to hospice services when appropriate and requested by the patient/legal representative.
• Completes timely and accurate documentation of encounters in the electronic medical record (EMR) to support medical necessity, coordination of care, quality/coding standards, practice metrics and hospice eligibility.
• Provides and documents advance care planning and end-of-life discussions for patients and caregivers.
• Promotes access to community resources and acts as a liaison by relaying information to other health care professionals and agencies to provide for continuity of care.
• Participates in Quality Assurance activities and committee service related to NP scope of practice and policies/procedures.
• Maintains consistent and on-going communications with referring and/or primary care provider regarding patient status and care provided.
• Promotes patient relations through confidentiality, privacy, and dignity.  Provides services in a quick and courteous manner with care and respect for the patient’s individual needs as well as the unique needs of the referring and partner organizations. . 
• Consults with physicians within the practice according to the collaborative practice agreement.
• Communicates with nursing home and other facility staff regarding goals and treatment plans.
• Provides educational support to the orientation process, ongoing staff development, and education about the organization’s services to referral sources, facilities, and the community.
• Maintains oversight of all allocated resources within assigned areas of responsibility including but not limited to time, expenses, supplies and labor and ensures pre-determined financial margins and/or clinical outcomes are achieved.
• Communicates respectfully and effectively with office support staff to promote optimal scheduling efficiency and productivity.  Adapts to schedule changes with a positive and flexible attitude and provides clinical coverage for other NPs, including contact by telephone or providing visits when needed.
• Working with the collaborating physician, serves to provide on call coverage and/or face to face visits as needed, if approved and requested to function in these roles by the Director of Medical Affairs.
• Participates in Palliative IDT meetings working collaboratively with other members of the Palliative Care team to ensure patients continue to receive high quality palliative care and hospice care when eligible.

Essential Functions for all NP Roles:

• May serve as attending provider for hospice patients if approved and requested to function in this role.
• Proactively promotes census growth within designated region(s) and seeks to offer care that meets the unmet diverse needs of the community.
• Adjusts to changes in workload, schedules based on changing departmental/organizational priorities.
• Is an active participant in Medical Staff Meetings. Attends in-person meetings as often as possible.
• Duties as assigned with the Nurse Practitioner scope of practice. This could include collaboration on research, education, innovative clinical partnerships, and new business development at the discretion of their supervisor.
• Supports other team members through collaboration on complex cases.
• Maintains a high level of professionalism in all communications with internal and external contacts responding promptly and professionally to all concerns, questions, and deadlines.   
• Models and promotes knowledge of end of life care philosophies and articulates and promotes the NSCC vision, mission, and values locally, statewide, and nationally, when appropriate.
• Adheres to NorthStar Care Community Code of Conduct, policies, procedures, protocols and processes and all regulatory and legal requirements.
• Adheres to the NorthStar standards to care for every person, every time, 100% of the time.

Essential Functions for NP Clinical Lead (Administrative) Role – Approximately 20% of Time:

• Support the achievement of organizational strategic goals and key performance indicators, including quality, productivity, patient access, patient satisfaction and clinical outcomes.
• Support provider scheduling, resource allocation, and staffing strategies to maximize patient access and operational efficiency.
• Serves as the clinical resource and change leader, promoting innovation, continuous improvement and a culture of accountability.  Modeling clinical excellence, professionalism, and the NSCC vision, mission, and values.
• Assists in the hiring process for NP candidates, including participation in interviews, assessment of clinical knowledge and organizational fit, and provision of input and recommendations to the AVP of Palliative Care.
• Assists in the onboarding and orientation of newly hired NPs, including coordination of preceptorship and field mentoring, review of documentation and workflow standards, and monitoring of progress toward independent practice.
• Provides ongoing clinical feedback, coaching, and mentoring to NPs within the assigned region(s), including through annual joint visits, bi-annual documentation review, and case discussion, and shares observations with the AVP of Palliative Care and the Director of Medical Affairs to support professional development and performance review.
• Provides clinical perspective and frontline NP input in the development, revision, and implementation of organizational processes, workflows, policies, protocols, and quality initiatives affecting NP practice.
• Serves as a liaison between regional NPs and medical and administrative leadership, communicating organizational updates and elevating clinical and operational concerns, barriers, and improvement opportunities.
• Attends meetings at the direction of the AVP of Palliative Care, including but not limited to Palliative Operations, and others.
• Acts as regional representation at meetings, palliative operations and palliative all staff
• Maintains the intended balance of approximately 80% direct clinical care and 20% administrative responsibilities, adjusting as needed based on operational priorities in consultation with the AVP of Palliative Care.

Marginal Functions:   Performs other related duties as assigned.

Supervision:   Collaborates clinically with the designated supervising physician(s) for patient care guidance related to hospice and/or palliative care. Reports administratively to the AVP of Palliative Care. Provides clinical leadership, mentorship, and feedback to NPs within the assigned region(s). 

Working Relationships:

Internal:            Extensive contact with all members of the interdisciplinary team and various staff at all levels; frequent contact with NSCC physicians.

 

External:           Extensive contact with patients and family members; frequent contact with referring physicians, extended care facilities, hospital nursing and physician staff, other contracted agencies, facilities and community programs as needed.

Qualifications:

• Current licensure in the state where serving as a Nurse Practitioner, and maintain such licensure in accordance with applicable laws and regulations and perform within the scope specified.
• Master’s degree in Nursing with advanced skills in physical assessment.
• Minimum of three years clinical nursing experience and/or at least one year of post-graduate clinical nursing experience desirable in the hospice and palliative care field.
• Minimum of two years of experience as a Nurse Practitioner in hospice and/or palliative care, with demonstrated clinical excellence, preferred.
• Demonstrated leadership ability, including the capacity to mentor, coach, and provide constructive clinical feedback to peers, required.
• Board certification as an Advanced Practice Hospice and Palliative Nurse (ACHPN) preferred.
• Highly skilled in advanced nursing practice and a demonstrated ability to assess and respond to the needs of patients and families required.
• Understanding of performance improvement with the ability to communicate and operationalize performance improvement initiatives at the departmental and organizational level required.
• Ability to effectively use technology such as cell phones and the electronic medical record (EMR) in support of management and clinical operations.
• Excellent interpersonal skills, sound judgment, effective organizational, prioritization and follow- through skills, attention to detail, tact, dependability, emotional intelligence, the ability to maintain confidentiality and promote positive, constructive relationships with communication and collaboration at all levels required.
• Must be able to read, write and speak English fluently and be able to communicate orally and in writing in internal and external relationships for all essential job functions.
• Ability to prioritize multiple demands.  Demonstrates integrity and flexibility and participates actively in change and quality improvement initiatives.
• The physical demands of the position include: vision, effective speech and hearing for extensive telephone contact; repetitive motion; traveling; driving or riding in motor vehicle; standing, sitting, walking, bending, reaching, and stretching; lifting up to forty-five (45) pounds unassisted and the ability to assist in lifting patients using appropriate lifting techniques and/or devices.
• Proof of current tuberculin testing required.  Patient contact will not be allowed until tuberculin clearance is documented.
• Must have reliable transportation to be able to travel and maintain the rigors of a busy schedule.  Frequently works variable hours/days; activities and workload may require extended days. 
• Must be eligible to work in the United States.

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