Housecall Providers

Housecall Providers is a Portland area nonprofit organization and one of the largest providers of medical care exclusively in the home in the Western United States. We are proving every day that in home medical services for homebound and chronically ill patients can improve health outcomes, increase patient comfort, reduce health care costs and increase provider satisfaction. We are a proud part of the CareOregon family of health organizations.

Our Mission
Improving lives by bringing health care home.

Our Vision
To sustainably transform home-based medicine so all homebound adults and those living with serious illness have access to care that improves their quality of life.

Our Values
Compassion and respect, authentic relationships, collaboration, courage, social justice.

Diversity Statement

We embrace the diversity of our employees, patients, and those who care for them. Through awareness and advocacy, we are working to create health equity by recognizing and reducing barriers that affect non-dominant groups within Housecall Providers and our communities at large.

The quadruple aim is real at Housecall Providers
In home medical care for homebound patients is proven to increase patient comfort, improve health outcomes, reduce health care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ensuring greater patient comfort, improved health outcomes and care team satisfaction. With the population aging, more people are suffering from multiple chronic conditions and degenerative diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system.

If you receive an offer of employment for this position, it is contingent on the satisfactory completion of a pre-employment background check, immunization review, and drug screen (including THC/Marijuana). CareOregon is a federal contractor and must comply with all federal laws.

Job Summary

The Hospice and Palliative Care Nurse Practitioner works in collaboration with staff to provide professional, comprehensive, quality medical care with a focus on symptom palliation and end-of-life care to hospice and palliative care patients under the direction of the supervising Medical Director. Care may be provided directly, through face to face or telehealth visits at the patient's place of residence/facility/hospital or indirectly by advising and directing members of the interdisciplinary team. This position also identifies opportunities to improve care delivery, uses resources effectively, and ensures compliance with legal, regulatory, and clinical policies and procedures.

Essential Responsibilities

Clinical Services and Care

• Assists in ensuring Housecall Providers remains compliant with CMS guidelines by helping to complete face-to-face encounters in a timely fashion.
• Documents and shares information to assist in determining initial and continuing eligibility of patients for hospice or palliative care services, including evidence of end-stage disease progression.
• Engages in independent decision making about a patient's healthcare concerns and provide services on an as needed basis; this may include managing urgent medical issues by advising and supporting on-call nursing staff or making patient visits.
• Provides education, counseling, and guidance to patients, families, and caregivers about medical issues, goals of care, and hospice or palliative care services.
• Helps to coordinate case management activities for assigned patients.
• Assesses and counsels patients regarding palliative care needs; determines need for specialty and rehabilitative services and makes appropriate referrals.
• Collaborates with the patient's attending physician and the interdisciplinary team (IDT) to review/update/implement the patient's individual plan of care and ensure that the needs of the patient and caregiver are being met.
• Reviews treatment plan in order to prescribe or recommend medications to ensure adequate symptom management; initiates and/or continues medical regimes for new hospice patients; reviews medication to ensure they are medically necessary, effective, and cost effective.
• Provides compassionate anticipatory guidance through decline due to chronic disease and provides high quality palliative care focused on the goals of the patient and family.
• In conjunction with the hospice or palliative care team, participates in family meetings to educate patients and families on medical conditions and the risks and benefits of treatments or medications.
• Manages complex clinical situations requiring a high level of responsibility, application of advanced subject knowledge, and significant independent judgment and initiative.
• Delivers quality care while maintaining all company metrics pertaining to productivity.
• Provides coverage for clinical colleagues in their absence.
• May be required to work after hours and weekends.

Administration

• Participates in staff and professional conferences; consults on and assists in the development of in-service training and orientation activities in areas of treatment and care of the patient population; participate in peer review.
• Attends and participates in all required staff meetings and other ad hoc committees as assigned.
• Participates in quality improvement activities as assigned.
• Completes and maintains medical records according to agency protocols and in support of quality metrics.
• As assigned by the Medical Director, may train, and assess performance of other providers.
• Participates in the development and updating of patient care policies and emergency procedures.
• Participates in resolution of interpersonal conflict and issues of clinical and ethical concerns.
• Maintains current knowledge of the latest research and trends in hospice and palliative care and pain/symptom management.
• Proposes, participate, and implement process improvements.

Organizational Responsibilities

• Perform work in alignment with the organization's mission, vision and values.
• Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization's strategic goals.
• Adhere to the organization's policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Master's degree from an accredited advanced nurse practitioner program
• Licensed nurse practitioner in the state of Oregon (ANCC or AANP certified)
• Minimum one year of experience as a nurse practitioner
• Drug Enforcement Administration (DEA) license
• Valid driver's license, acceptable driving record, and automobile liability coverage or access to an insured vehicle
• CPR (BLS) certification at hire or within 6 months in position

Preferred

• Certification in Hospice and Palliative Care (CHPN) at hire or within one year in position.
• 2 years' experience in geriatrics, safety net populations and/or hospice and palliative medicine
• Experience in performing medical home visits
• Experience with the mental health, substance abuse and behavioral health issues of a safety net population
• Experience with medical ethics and quality improvement methodology

Knowledge, Skills and Abilities Required

Knowledge

• Current clinical and regulatory knowledge regarding patient prognosis and hospice eligibility
• Knowledge of the ethical and medico-legal aspects of medical practice
• Knowledge of the principles and practices of public health, including familiarity with epidemiology, health services delivery and financing systems, and environmental health
• Knowledge of the population served in adult health, including culture, demographics, patterns of disease, barriers to care and other unique features or special needs
• Knowledge of available interventions and medications, the expected palliative benefits in the hospice population, and the likely ability to meet the needs of an individual patient
• Knowledge of Federal, State and Local regulations, Hospice Medicare Conditions of Participation, and HIPAA privacy rules and regulations

Skills and Abilities

• Ability to assist in the development and implementation of appropriate outcome tools, metrics, and assessment strategies to inform quality outcome, safety, and performance improvement

• Ability to understand the needs of and work with dying individuals in a hospice setting
• Outstanding communications and conflict resolution skills; ability to provide emotional support to patients, caregivers, and the hospice team
• Ability to communicate effectively with diverse staff and patients, their families, and caregivers while maintaining professional boundaries
• Problem-solving skills
• Skilled in use of electronic medical records
• Proficient in the practice of hospice and palliative care, particularly in a geriatric population
• Cultural competence and ability to work effectively with people from all walks of life
• Characteristics of compassion, commitment, and integrity that are required for success in this position
• Ability to work a flexible schedule, including evenings and weekends
• Ability to work both independently and collaboratively
• Ability to work under pressure to meet deadlines
• Ability to take initiative and utilize innovative techniques and ingenuity
• Ability to plan, prioritize and coordinate multiple projects or tasks
• The following cognitive or mental requirements are necessary on a daily basis:
  • Critical thinking
  • Reading, writing, mathematics
  • Drawing conclusions from written or computer-generated materials
  • Implementing recommendations by coordinating people and/or other resources
  • Developing plans, procedures, goals, strategies, or processes
  • Clear verbal articulation
  • Ability to tolerate and manage stress and grief
  • Maintain effective professional boundaries for resiliency
  • Accept direction and feedback from manager and/or the leadership or hospice team

• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, hear, speak clearly, sit, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to stand for at least 3-6 hours/day

• Ability to lift, carry, push, pull, crouch, crawl, reach, climb stairs, walk and/or pinch small objects for at least 3 hours/day
• Ability to operate a motor vehicle

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

H Hazards: May include, but not limited to, physical, ergonomic, and biological hazards. (Member Facing)

Equipment: General office equipment and/or mobile technology

Travel: Requires travel outside of the workplace at least weekly; the employee's personal vehicle may be used. Driving infractions will be monitored in accordance with organizational policy.

Schedule: May be required to work after hours and weekends.

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.