Nurse Practitioner (NP)

Come join our amazing palliative care team at Northstar Palliative Care, an affiliate of Hospice of Michigan. As a palliative care nurse practitioner you will be responsible for the evaluation and management of home based palliative care patients who have a limited prognosis. By focusing on symptom management and advanced care planning you will help patients and families when they need your care the most; while facing a significant chronic disease. Our expert team of clinicians is comprised of over 20 physicians and nurse practitioners across the state of Michigan who are all dedicated to improving quality of life of those patients who are seriously or terminally ill.

Here at Hospice of Michigan, we are proud to be the largest community based not-for-profit hospice in the State of Michigan. As part of the Northstar Care Community, Hospice of Michigan cares for over 1400 patients each day in 56 counties in lower Michigan, we are a statewide organization that serves patients in the communities which they are a part of. We are dedicated to putting the needs of patients and families first while also promoting and supporting the not-for-profit mission of other hospices across the country.

Job Summary: Assumes responsibility and accountability for the Nurse Practitioner (NP) role for patients within the NorthStar Care Community (NSCC) as detailed below. Provides services under collaborative practice agreement with the physicians of the practice. Participates in the on-call schedule per on-call policy.

Essential Functions for Hospice NP Role:

1. Completes and documents an accurate history and physical examination and documents findings for Face to Face and/or certification of terminal Illness for physician review of initial and ongoing hospice eligibility.
2. In collaboration with the hospice and attending physicians, works to establish and meet the goals of care, coordinates with internal and external members of the patient’s health care and family/caregiver teams, and makes recommendations for identified immediate needs and ongoing treatment plans.
3. Completes timely and accurate documentation of all activities in the electronic medical record (EMR).
4. Provides assistance to patients/families in goal setting, care plan development and end-of-life discussions.
5. Promotes access to community resources and acts as a liaison by relaying information to other health care professionals and agencies to provide for continuity of care.
6. Participates in Quality Assurance activities and committee service related to NP scope of practice and policies/procedures.
7. Maintains consistent and on-going communications with attending physician regarding all aspects of care.
8. Promotes patient relations through confidentiality, privacy, and dignity.  Provides services in a quick and courteous manner with care and respect for the patient’s individual needs. 
9. Consults with physicians within the practice according to the collaborative practice agreement.
10. Communicates with nursing home and other facility staff regarding goals and treatment plans.
11. Provides educational support to the orientation process, ongoing staff development, and education about the organization’s services to referral sources, facilities, and the community.
12. Maintains oversight of all allocated resources within assigned areas of responsibility including but not limited to time, expenses, supplies and labor and ensures pre-determined financial margins and/or clinical outcomes are achieved.
13. Provides support to physicians as needed, including attending IDT with physician when requested.
14. Acts as a representative of the NorthStar Community in the facilities, homes, and communities of the patients we serve. This includes identifying and solving problems within the NP scope of practice and patient care plan that are being encountered as part of the care delivered.

Essential Functions for Palliative NP Role:

1. Completes an accurate history and physical examination and provides diagnosis and treatment of symptoms, including recommending or prescribing of medications and treatments (as preferred by referring provider) according to the collaborative agreement and NP scope of practice laws and as approved by the Director of Medical Affairs.
2. Working with the collaborating physician, identifies and documents medical necessity for home/facility encounters, including appropriateness for initiating services, timing/necessity of follow up encounters, and appropriateness for hospice evaluation and/or discharge from practice.
3. Works to establish and meet the goals of care, coordinates with internal and external members of the patient’s health care and family/caregiver teams, and coordinates referral to hospice services when appropriate and requested by the patient/legal representative.
4. Completes timely and accurate documentation of encounters in the electronic medical record (EMR) to support medical necessity, coordination of care, quality/coding standards, practice metrics and hospice eligibility.
5. Provides and documents advance care planning and end-of-life discussions for patients and caregivers.
6. Promotes access to community resources and acts as a liaison by relaying information to other health care professionals and agencies to provide for continuity of care.
7. Participates in Quality Assurance activities and committee service related to NP scope of practice and policies/procedures.
8. Maintains consistent and on-going communications with referring and/or primary care provider regarding patient status and care provided.
9. Promotes patient relations through confidentiality, privacy, and dignity.  Provides services in a quick and courteous manner with care and respect for the patient’s individual needs as well as the unique needs of the referring and partner organizations. . 
10. Consults with physicians within the practice according to the collaborative practice agreement.
11. Communicates with nursing home and other facility staff regarding goals and treatment plans.
12. Provides educational support to the orientation process, ongoing staff development, and education about the organization’s services to referral sources, facilities, and the community.
13. Maintains oversight of all allocated resources within assigned areas of responsibility including but not limited to time, expenses, supplies and labor and ensures pre-determined financial margins and/or clinical outcomes are achieved.
14. Communicates respectfully and effectively with office support staff to promote optimal scheduling efficiency and productivity.  Adapts to schedule changes with a positive and flexible attitude and provides clinical coverage for other NPs, including contact by telephone or providing visits when needed.
15. Working with the collaborating physician, serves to provide on call coverage and/or face to face visits as needed, if approved and requested to function in these roles by the Director of Medical Affairs.
16. Participates in Palliative IDT meetings working collaboratively with other members of the Palliative Care team to ensure patients continue to receive high quality palliative care and hospice care when eligible.

Essential Functions for all NP Roles: 

1. May serve as attending provider for hospice patients if approved and requested to function in this role.
2. Proactively promotes census growth within designated region(s) and seeks to offer care that meets the unmet diverse needs of the community.
3. Adjusts to changes in workload, schedules based on changing departmental/organizational priorities.
4. Is an active participant in Medical Staff Meetings. Attends in-person meetings as often as possible.
5. Duties as assigned with the Nurse Practitioner scope of practice. This could include collaboration on research, education, innovative clinical partnerships, and new business development at the discretion of their supervisor.
6. Supports other team members through collaboration on complex cases.
7. Maintains a high level of professionalism in all communications with internal and external contacts responding promptly and professionally to all concerns, questions, and deadlines.   
8. Models and promotes knowledge of end of life care philosophies and articulates and promotes the NSCC vision, mission, and values locally, statewide, and nationally, when appropriate.
9. Adheres to NorthStar Care Community Code of Conduct, policies, procedures, protocols and processes and all regulatory and legal requirements.
10. Adheres to the NorthStar standards to care for every person, every time, 100% of the time.

Qualifications:

1. Current licensure in the state where serving as a Nurse Practitioner, and maintain such licensure in accordance with applicable laws and regulations and perform within the scope specified.
2. Master’s degree in Nursing with advanced skills in physical assessment.
3. Minimum of three years clinical nursing experience and/or at least one year of post-graduate clinical nursing experience desirable in the hospice and palliative care field.
4. Board certification as an Advanced Practice Hospice and Palliative Nurse (ACHPN) preferred.
5. Highly skilled in advanced nursing practice and a demonstrated ability to assess and respond to the needs of patients and families required.
6. Understanding of performance improvement with the ability to communicate and operationalize performance improvement initiatives at the departmental and organizational level required.
7. Ability to effectively use technology such as cell phones and the electronic medical record (EMR) in support of management and clinical operations.
8. Excellent interpersonal skills, sound judgment, effective organizational, prioritization and follow- through skills, attention to detail, tact, dependability, emotional intelligence, the ability to maintain confidentiality and promote positive, constructive relationships with communication and collaboration at all levels required.
9. Must be able to read, write and speak English fluently and be able to communicate orally and in writing in internal and external relationships for all essential job functions.
10. Ability to prioritize multiple demands.  Demonstrates integrity and flexibility and participates actively in change and quality improvement initiatives.
11. The physical demands of the position include: vision, effective speech and hearing for extensive telephone contact; repetitive motion; traveling; driving or riding in motor vehicle; standing, sitting, walking, bending, reaching, and stretching; lifting up to forty five (45) pounds unassisted and the ability to assist in lifting patients using appropriate lifting techniques and/or devices.
12. Proof of current tuberculin testing required. Patient contact will not be allowed until tuberculin clearance is documented.
13. Must have reliable transportation to be able to travel and maintain the rigors of a busy schedule.  Frequently works variable hours/days; activities and workload may require extended days. 
14. Must be eligible to work in the United States.

This description is intended to indicate the kinds of tasks and levels of work required of the position.  It is not intended to limit the assignment of other duties.