Autonomous Practice APRN Home Health Full Time

Job description

Position Summary : Oversees and provides primary care services to clients at an identified higher risk for rehospitalization by utilizing specific patient and family evidence-based interventions found in research validated care transition models. Leads a cohesive team in delivering at home clinical support and guidance to avoid adverse events. Collaborates continuously with other team members including medical staff to ensure care coordination and timely interventions based on assessed changes in status. Job Responsibilities: Job Qualifications: Autonomous Practice APRN license in the State of Florida - Practices at the APRN level to ensure delivery of care coordination, including obtaining new medical orders that support clinical and social services according to the individualized patient plan of care - Utilizes the Coleman Care Transitions model’s four (4) pillars to guide practice, prioritize care delivery, and facilitate self-care with evidence-based interventions. - Provides medication reconciliation and medication adherence teaching to identified clients. Sets goals for self (family) management of medications - Performs comprehensive assessment to facilitate understanding of...