NURSE PRACTITIONER

Signify Health seeks an In-Home Nurse Practitioner or Physician Assistant to deliver comprehensive clinical evaluations in patients' homes. In this field-based role, you will perform detailed health risk assessments, review medical histories and medications, and conduct exams for primarily adult and senior populations. Using mobile technology and EHR tools, you'll document findings, identify care gaps, and create evidence-based care plans that support value-based care goals. You will collaborate with interdisciplinary teams, educate patients and caregivers, and escalate high-risk concerns, helping improve outcomes and reduce costs for vulnerable populations.

Responsibilities

• Conduct comprehensive in-home health risk assessments for diverse adult and senior populations.
• Review medical histories, medications, and social determinants of health to identify care gaps.
• Perform focused physical exams, diagnostics, and preventive screenings using mobile technology.
• Develop evidence-based care plans and recommend follow-up with primary and specialty providers.
• Document encounters accurately in electronic health records and comply with value-based care protocols.
• Collaborate with Signify Health's interdisciplinary teams to coordinate services and resources.
• Educate patients and caregivers on chronic disease management, medications, and healthy lifestyle changes.
• Escalate high-risk findings and urgent clinical concerns according to established clinical guidelines.

Required Skills

• In-home clinical assessment
• Adult and geriatric primary care
• Chronic disease management
• Medication reconciliation
• Electronic health records (EHR) documentation
• Telehealth and mobile health technology
• Care planning and care coordination
• Diagnostic interpretation (labs, vitals, screenings)
• Patient and caregiver education
• Value-based care and risk adjustment knowledge