PNO Advanced Practice Registered Nurse- Remote Patient Monitoring Home Visits

Performance Network Operations (PNO) APRN-Remote Patient Monitoring

We are seeking an innovative, compassionate Advanced Practice Provider (APP) to collaborate with the PNO VP, Director of Care Management, Director of Strategy, and Associate Medical Director to stand up a Remote Monitoring program. This role would meet adult patients at Dartmouth Hitchcock Medical Center who are ready to be discharged and will be enrolled in a Remote Patient Monitoring Program.  Once discharged, APP will meet patient at their home to set up Remote Patient Monitoring equipment and perform an in-home assessment.   The APP will be expected to perform Home Based visits and or Telehealth for patients in the Remote Patient Monitoring program as needed with a focus on reducing readmission during the 30-day post discharge period.  This position will support the critical transition period between the inpatient and outpatient settings, and ensure safe, high quality, seamless care, and a positive experience for the patient and their family. The APP will work collaboratively with interdisciplinary teams to ensure high-quality, patient-centered care is delivered via Remote Patient Monitoring.  The APP will actively participate in program enhancement and creates an environment of collaboration between PNO, Primary Care/Specialty Care, and Hospital Medicine to support the care continuum.  Monday-Friday, no nights/ no call.

Key Responsibilities:

1. Assesses physical and psychosocial health status of patient and family by taking health histories and conducting comprehensive assessments and physical examinations via telehealth or during home visits.
2. Implements the use of innovative technology to support remote monitoring and health management, telehealth visits, and along with other program initiatives.
3. Responsible for accurate and complete coding (as needed) for attributed patients to ensure accurate depiction of population disease burden.
4. Consults and collaborates with a department physicians, APPs, or appropriate specialists to plan and manage the care for patients.
5. Conducts pre-visit chart reviews to support health care initiatives.
6. Ensures accuracy of elements in the Electronic Health Record.
7. Orders appropriate diagnostic/screening tests to evaluate patient’s current health status in collaboration with Primary Care Providers.
8. Prescribes and/or dispenses medication status in collaboration with Hospital Medicine and Primary Care Providers.
9. Provides patient education with emphasis on the promotion of health and wellness and the prevention of illness and disability.
10. Provides guidance and counseling for both individuals and families.
11. Demonstrates patient advocacy that insures the patient’s right to privacy, confidentiality, and informed consent.
12. Serves as a mentor for new APNs, nursing students, and department nursing staff.
13. Assumes responsibility to renew APRN license in a timely manner and maintain DEA registration.
14. Attends continuing education programs to ensure ongoing professional growth and development to meet licensure requirements.
15. Performs other duties as required or assigned.

Qualifications:

• Graduate of an accredited APRN program.
• Board certified by the American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC).
• Excellent communication, leadership, and collaboration skills. 
• Knowledge of healthcare regulations and compliance standards (e.g. HIPAA, telemedicine laws).

• Understanding of healthcare technology, virtual care platforms, and remote patient monitoring tools.

Preferred Qualifications:

• Experience with Home Based Visits
• Experience with transitions of care, from a primary or inpatient care aspect
• Three years of Nurse Practitioner experience

• Eligible for APRN licensure in the State of New Hampshire & Vermont
• Eligible for Federal DEA Registration.