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Advanced Practice Nurse Practitioner

78703 Austin, Texas Molina Healthcare

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JOB DESCRIPTION Job Summary
Provides medical oversight and expertise in appropriateness and medical necessity of health care services provided to plan members - targeting improvements in efficiency and satisfaction for member patients and providers, in addition to meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Demonstrates and facilitates conformance to Medicare, Medicaid, National Committee for Quality Assurance (NCQA) and other regulatory requirements.
- Reviews quality referred issues, focused reviews and recommends corrective actions.
- Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.
- Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and others as directed by the chief medical officer.
- Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review and manages the denial process.
- Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency and continuity of care.
- Ensures that medical decisions are rendered by qualified medical personnel, not influenced by fiscal or administrative management considerations, and that the care provided meets the standards for acceptable medical care.
- Ensures that medical protocols and rules of conduct for plan medical personnel are followed.
- Develops and implements plan medical policies.
- Provides implementation support for quality improvement activities.
- Stabilizes, improves and educates primary care physicians and specialty networks; monitors practitioner practice patterns and recommends corrective actions if needed.
- Collaborates with contracting department in contract negotiations.
- Fosters clinical practice guideline implementation and evidence-based medical practices.
- Utilizes information technology and data analysts to produce tools to report, monitor and improve utilization management.
- Actively participates in regulatory, professional and community activities.
Required Qualifications
- At least 8 years of health care experience, including 5 years of clinical practice experience, 3 years utilization/quality program management experience, and 2 years managed care experience, or equivalent combination of relevant education and experience.
- Advanced Practice Registered Nurse (APRN) license. License must be active and unrestricted in the state of practice.
- Current clinical knowledge.
- Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations.
- Ability to work independently, with minimal supervision and demonstrate self-motivation.
- Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
- Excellent time-management and prioritization skills; ability to focus on multiple projects simultaneously and adapt to change.
- Excellent problem-solving and critical-thinking skills.
- Ability to work in a high-pressure environment.
- Ability to maintain attendance to support required quality and quantity of work.
- Ability to maintain confidentiality and comply with health insurance portability and accountability act (HIPAA).
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
- Knowledge of applicable state, federal and third party regulations.
- Strong verbal and written communication skills.
- Microsoft Office proficiency, and ability to navigate an electronic medical record (EMR) system.
Preferred Qualifications
- Board certification (primary care preferred).
- Peer review, medical policy/procedure development, and/or provider contracting experience.
- Experience with National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data Information Set (HEDIS), Medicaid, Medicare and Pharmacy Benefit Management (PBM), Group/IPA practice, capitation, health management organization (HMO) regulations, managed health care systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management and evidence-based guidelines.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $117,731 - $275,491 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Advanced Practice Provider - Nurse Practitioner - CareBridge - Virtual

78703 Austin, Texas Elevance Health

Posted 2 days ago

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Job Description

**Carebridge Health is a proud member of the Elevance Health family of companies within our Carelon business. Carebridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home care and community-based services.**
$5,000 Sign on Bonus
**Seeking Nurse Practitioners licensed in TWO or more of the following states: MA, VA, TN, FL, IN, OH, TX, KS, AZ, IA, NM, NJ, HI and must have an active RN Compact license.**
**Location: Virtual** - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
**Work Shift:** **OVERNIGHT 7pm - 7am CST** **; The NP will work six (6) 12-hour shifts and one (1) 8-hour shift in a two-week period, which includes Saturday and Sunday every other weekend.**
The **Advanced Practice Provider** is responsible for collaborating with company physicians, the patient's other physicians and providers, and their family members to develop complex plans of care in accordance with the patient's health status and overall goals and values. Provides clinical and non-clinical support to patients.
Primary duties may include but are not limited to:
+ Provides primary and urgent health care via telephone and tele video modalities to patients who receive home and community-based services through state Medicaid programs, dual eligible members and other membership as assigned by our MCO partners.
+ Develops and implements clinical plans of care for adult patients facing chronic and complex conditions (e.g., co-morbid medical and mental health diagnoses, limited personal resources, chronic medical conditions.).
+ Gathers history and physical exam and diagnostics as needed and then develops and implements treatment plans given the patient's goals of care and current conditions. Identifies and closes gaps in care.
+ Meets the patient's and family's physical and psychosocial needs with support and input from the company's inter-disciplinary team.
+ Educates patients and families about medication usage, side effects, illness progression, diet and nutrition, medical adherence and crisis anticipation and prevention.
+ Maintains contact with other clinical team members, patients' other physicians and patients' other medical providers to coordinate optimal care and resources for the patient and his or her family in a timely basis and consistent with state regulations and company health standards and policy.
+ Maintains patient medical records and medical documentation consistent with state regulations and company standards and policy.
+ Participates in continuing education as required by state and certifying body.
+ Prescribes medication as permitted by state prescribing authority.
Position Requirements:
+ Requires an MS in Nursing.
+ Requires an active national NP certification.
+ Requires valid, current, active and unrestricted Family or Adult Nurse Practitioner (NP) license in applicable states.
+ Experience working with Electronic Medical Records (EMR) required.
+ Requires 2+ years of experience in managing complex care cases.
Preferred qualifications, skills and experiences:
+ Emergency Room and/or Urgent Care experience is strongly preferred.
+ Possession of DEA registration or eligibility preferred.
+ Experience in managing complex care cases for developmental disabilities and chronically ill patients is strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $07,680 to 185,748
Locations: Hawaii, New Jersey, Cleveland, OH, Massachusetts
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _._
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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Nurse Practitioner Primary Care

78703 Austin, Texas Baylor Scott & White Health

Posted 1 day ago

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Job Description

Join our dedicated team at Baylor Scott & White Health in Austin, TX. This is an excellent opportunity to join a collaborative, patient-centered team focused on delivering exceptional care to the North Austin community. Enjoy a balanced weekday schedule, strong clinical support, and the resources of the largest not-for-profit health system in Texas.
**POSITION HIGHLIGHTS**
Schedule: Full-time; Monday-Friday, 8:00 AM - 5:00 PM (no weekends or nights)
Practice Setting: Outpatient only
Patient Population: Ages 18+; diverse adult population
Team Structure: Collaborative team of 4 Physicians and 3 APPs
Support Staff: Dedicated MA per provider, onsite lab, and imaging
EMR: Epic
Additional Highlights: Convenient central location, strong leadership support, and excellent work-life balance
**LOCATION HIGHLIGHTS**
At Baylor Scott & White Clinic - Austin Jollyville Road, we care for patients age 18 years and older. Conveniently located in north Austin, we're dedicated to helping the communities around the Austin area live their healthiest lives. The care team works together to create a care plan centered around you. This experienced team is here for every step of your health journey. Our goal is simple: to help you get better and stay that way.
**JOB SUMMARY**
The Nurse Practitioner (NP) Primary Care is a licensed, certified, non-physician healthcare provider who actively renders direct patient care and possesses delegated prescriptive authority, is credentialed and privileged, and whose service is billed as an independent billing provider, as recognized by Medicare and Medicaid within the healthcare systems, and in accordance with the appropriate board. The Advanced Practice Provider provides medical care based upon the scope of practice as delineated by the supervising physician.
These providers typically provide care to patients in an internal medicine, family medicine, geriatric or pediatric clinic.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Assesses the physical and mental condition of patients by performing and obtaining comprehensive or problemfocused physical examinations and medical histories.
Orders, collects, interprets, and evaluates laboratory and other diagnostic tests to assess patient problems and health care needs.
Prescribes, recommends and/or employs medical drug therapies or other forms of related therapeutic treatments and procedures or performs indicated procedures in accordance with approved protocols/policies with attention to efficacy, safety, and cost.
Recommends interventions to modify behavior associated with health risks.
Formulates and implements comprehensive outcomes-based patient treatment plans based on patient assessments, evidence-based medicine, standards of care, professional practice guidelines and in collaboration with physicians and other interdisciplinary team members when appropriate. Evaluates patient's response to health care provided and the effectiveness of care.
Counsels patients and families regarding medical processes, management of the health illness/condition, medication, nutrition, and health promotion. Counsels patients about drug regimens and possible side effects or interactions with other substances such as food supplements, over the counter medications and herbal remedies.
Maintains appropriate records detailing the patient's treatment plans and outcomes. Initiates timely consultation and referral when the problem exceeds scope of practice and/or expertise.
Provide consultation level services for conditions /problems related to the Provider's specialty and training.
Perform invasive procedures specific to scope of practice and competency of the provider as delegated by supervising Physician.
May provide care to a panel of patients in a team based model focusing on acute and chronic illness management, as well as population health.
**KEY SUCCESS FACTORS**
Knowledge of information and techniques needed to diagnose and treat human injuries, diseases, and deformities to include symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.
Knowledge of principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions.
Verbal and written communication skills.
Interpersonal skills.
Critical thinking and complex problem-solving skills.
Skill in the use of computers and related software applications.
Ability to develop and implement comprehensive outcomes-based patient treatment plans.
Ability to counsel patients concerning medical and psychological/psychiatric conditions, treatment plans, and behavior modification.
Ability to interpret and evaluate laboratory and other diagnostic tests.
Texas RN licensure or RN licensure with compact privilege from a state that is party to the Nurse Licensure Compact for RNs and LVNs & Texas APRN.
Current license to practice as a Nurse Practitioner in the state of Texas.
Basic Life Support within 30 days of hire or transfer.
National Nurse Practitioner certification in area of specialty.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - Grad of an Accredited Program
- EXPERIENCE - Less than 1 Year of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
 Nurse Practitioner (NP)
 Registered Nurse (RN)
 Basic Life Support (BLS): BLS or BLS within 30 days of hire or transfer.
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78716 Austin, Texas DocCafe

Posted 1 day ago

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part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

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DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78716 Austin, Texas DocCafe

Posted 1 day ago

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Job Description

part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

---

Register now to apply for this job and for access to 120,000+ other openings.

DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78701 Austin, Texas DocCafe

Posted 1 day ago

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part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

---

Register now to apply for this job and for access to 120,000+ other openings.

DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78716 Austin, Texas DocCafe

Posted 1 day ago

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Job Description

part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

---

Register now to apply for this job and for access to 120,000+ other openings.

DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78716 Austin, Texas DocCafe

Posted 1 day ago

Job Viewed

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Job Description

part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

---

Register now to apply for this job and for access to 120,000+ other openings.

DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78716 Austin, Texas DocCafe

Posted 1 day ago

Job Viewed

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Job Description

part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

---

Register now to apply for this job and for access to 120,000+ other openings.

DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

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Family Practice/Primary Care Nurse Practitioner - Competitive Salary (Austin)

78716 Austin, Texas DocCafe

Posted 1 day ago

Job Viewed

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Job Description

part time

DocCafe has an immediate opening for the following position: Nurse Practitioner - Family Practice/Primary Care in Austin, Texas.

DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.

---

Register now to apply for this job and for access to 120,000+ other openings.

DocCafe Offers:
  • Free Physician and Advanced Practice Job Search:
    Easily search, review and apply to jobs that meet your requirements. Plus, set up e-mail alerts for when new jobs are added that meet your search criteria.
  • Professional Profile:
    Attract employers with a profile page that includes your CV, credentials and other medical professional information.
  • Confidentiality:
    Decide which information you want to share and when you appear in an employers search results.
  • Career Matching Support:
    Our experienced team can match you to your dream based on your unique preferences.

Get started with DocCafe today.

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