Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider

This is a fully remote position, open to applicants in Arizona, +6 more states.

📋 Description

• Develop the Transitions of Care (TOC) Program at Devoted Medical.

• Deliver virtual care during the 30-day period following patients’ discharge from a hospital or skilled nursing facility.

• Conduct thorough initial TOC visits, assessing medical conditions, medications, functional status, and psychosocial needs.

• Execute post-discharge medication reconciliation and issue prescriptions, lab tests, imaging, referrals, home health, and DME orders.

• Provide education on specific diseases, alert guidance for red flags, and contingency plans for worsening symptoms.

• Perform acute symptom TOC and virtual urgent care consultations; diagnose and manage patients while determining the appropriate level of care.

• Engage in interdisciplinary TOC rounds for patients at high risk of readmission.

• Collaborate with RNs, LPNs, nurse case managers, clinical guides, and clinical coordinators.

• Aid in the clinical education of the overall team.

• Promote safe and transparent communication among team roles and facilitate patient escalations.

• Utilize Devoted’s electronic health information system and offer feedback to enhance its interface.

• Take part in quality improvement initiatives and pilot projects.

• Assist in the development of new clinical or organizational programs and integrate innovative virtual care practices as the role progresses.

⛳️ Requirements

• Minimum of 3 years of experience in a hospital, post-hospital, or primary care setting, with a clear understanding of common hospital discharge diagnoses, post-discharge needs, and the medical management necessary to prevent readmissions.

• Ability to commit to a full-time schedule, working five 8-hour days per week (Monday-Friday, 8:30 AM - 5:00 PM; CST/PST/MST preferred), including one weekend shift per month.

• Strong team-oriented individual, eager to collaborate in an interdisciplinary team to provide optimal patient care.

• Required licensure and good standing in current or future Devoted states. Must be able and willing to obtain licensure in required states within 90 days of hire.

• Active RN and APRN licenses in good standing or an active Physician Assistant license in good standing.

• Current BLS certification at the time of hire, which must be maintained during employment at Devoted Medical.

• Experience in internal medicine, urgent care, emergency medicine, hospital medicine, post-acute care, and/or geriatrics.

• Familiarity with conducting visits via telehealth video platforms.

• Proven experience in managing post-transition patients and recognizing the need for immediate interventions.

• Background in managing acute/chronic disease exacerbations, including CHF exacerbations, diabetic emergencies, COPD exacerbations, and hypertensive emergencies.

🏝️ Benefits

• Employer-sponsored health, dental, and vision plans with low or no premium.

• Generous paid time off.

• $100 monthly stipend for mobile or internet expenses.

• Stock options available for all employees.

• Eligibility for bonuses for all roles, excluding Director and above.

• Parental leave program.

• 401K program.