Nurse Practitioner - Care at Home in Johnston, RI

The Care at Home Nurse Practitioner (CAH-NP) delivers in-home care for medically complex, high-risk patients by building trusting relationships, conducting clinical assessments, and managing chronic conditions. They work closely with patients, families, caregivers, and primary care providers to address medical, social, and environmental needs. The CAH-NP supports recovery and prevents unnecessary hospitalizations through patient education, medication management, care coordination, and resource navigation-all with the goal of helping patients heal safely and comfortably at home.Our Values: Put Patients FirstEmpower Entrepreneurial Provider and Care TeamsOperate with Integrity & ExcellenceBe InnovativeWork As One TeamConduct comprehensive initial home assessments to establish a foundation for ongoing in-home medical care.Diagnose and treat patients safely in the home setting, in full collaboration with the Primary Care Provider (PCP).Address HEDIS care gaps during visits through Point of Care testing.Complete home visits within 72 hours of patient discharge from a hospital or skilled nursing facility.Manage a patient panel of 150-180 individuals, meeting daily contact goals of 4 in-home visits per day to assess and deliver clinical care.Coordinate care with the PCP, Medical Director, CAH Registered Nurse, and Care Coordinator to ensure continuity and quality of care.Actively participate in weekly interdisciplinary rounds to collaborate, share expertise, and mobilize additional support for patients.Review hospital discharge plans, assess for risks of readmission, and proactively address potential challenges to recovery.Provide patient and caregiver education to recognize early signs of clinical decline, manage medications, and encourage timely outreach to the Care at Home team.Coordinate care by involving interdisciplinary colleagues (e.g., Palliative Care, Pharmacy, Social Work, Community Health Workers) as needed.Build collaborative relationships with Home Health and Visiting Nurse services, while maintaining a distinct role and value proposition for patients and families.Graduate of an accredited Nurse Practitioner (NP) program with an active, unrestricted NP license in the State of Rhode Island.Minimum of 2 years of clinical NP experience preferred.Strong clinical assessment skills with the ability to educate and empower patients and families in managing chronic conditions.Proven ability to build trusting relationships and communicate effectively with diverse patient populations.Comfortable providing care in patients' homes, respecting autonomy while effectively guiding care decisions.Capable of independently managing a panel of 150-180 patients, prioritizing tasks, and making sound clinical decisions with collaborative input as needed.Proficient with Electronic Health Records (EHR), Microsoft Office, and other standard digital tools (email, calendar, phone).Excellent written and verbal communication skills, with strong multitasking and organizational abilities.Valid, unrestricted driver's license required.Committed to maintaining professionalism, patient confidentiality, and compliance with HIPAA standards.This is a hybrid position that requires significant travel to patient homes throughout Rhode Island, predominantly in Providence. This is a full-time position. Expects hours are M-F 8:00 AM - 5 PM. Flexible work hours may be required to meet patient needs. No on-call or weekend coverage is required for this position. The target pay range for this role is $140,000 - $150,000 per year. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@networkmedicalmanagement.com to request an accommodation.Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.