Nurse Practitioner - Telemedicine Care, (Spanish) 100% Wfh

This role offers an experienced Nurse Practitioner the chance to provide meaningful care to medically complex patients primarily through virtual care.

You will join a collaborative interdisciplinary team focused on prevention, early intervention, and better patient outcomes. This position emphasizes autonomy, care coordination, and innovative approaches to home-centered healthcare in New Mexico.

Key Responsibilities:

• Provide clinical care and ongoing management through telehealth and remote care technologies.
• Manage medically complex Medicaid and Dual Eligible patient populations.
• Collaborate with physicians and interdisciplinary care team to develop and execute individualized care plans.
• Work closely with patients, families, caregivers, primary care providers, specialists, and health plan partners.
• Identify changes in patient health and intervene early to prevent unnecessary emergency visits and hospitalizations.
• Support patients through hospital admissions, discharges, and transitions back home.
• Participate in advance care planning and goals-of-care discussions with patients and families.
• Participate in a shared clinical triage and support model.
• Support quality initiatives including accurate documentation related to HCC coding, risk adjustment, STAR and HEDIS measures, and closure of quality gaps.
• Contribute to clinical best practices and help shape a growing and innovative care model

Languages:

• Spanish (preferred)