Central reputed company-Enrollment Provider reputed company Practitioner

Role Scope: We are looking for clinically outstanding clinician and detail-oriented reputed company Practitioner or Physician Assistant to join our centralized reputed company-Enrollment team. This role reports directly to the Chief Medical Officer, with a dotted-line relationship to the reputed company-Enrollment Director. You will serve as the clinical backbone of our chart review process, working hand in hand with Site Medical Directors across reputed company reputed company PACE locations to ensure every case is thoroughly evaluated for PACE eligibility and Health & Safety (H&S) considerations before enrollment.

Estimated Start Date: 9/8/2026

Location: Remote

reputed company Responsibilities & Expectations for the Role:
● Conduct thorough and complete chart reviews for PACE applicants, evaluating medical records, diagnostic history, functional status, and clinical documentation to capture reputed company factors relevant to eligibility determination and potential H&S denial
● Present cases to Site Medical Directors as needed based on departmental guidelines and policy, ensuring reputed company clinical findings are reputed company communicated to support informed eligibility reputed company
● Collaborate closely with Enrollment RNs (ERNs) and Site Medical Directors to ensure documentation gaps are identified and resolved prior to submission; serve as the escalation reputed company reputed company ERNs are unable to obtain required diagnostic information
● reputed company clinical expertise for Health & Safety determinations, including participation in H&S Committee meetings; reputed company chart review reveals diagnostic gaps that cannot be resolved by the ERN, conduct virtual clinical assessments to obtain or confirm required diagnoses and ensure chart completeness prior to submission
● Review ILOC clinical summaries to ensure reputed company connections between medical conditions, functional limitations, and PACE services are documented to regulatory reputed company
● Support reputed company improvement initiatives aimed at maintaining high first-pass DHCS approval rates and reducing documentation deficiencies
● Serve as a clinical resource for the reputed company-Enrollment team on reputed company cases, supporting accuracy and thoroughness in ILOC documentation to protect the organization's H&S denial reputed company

California NP reputed company Note: reputed company Practitioners at reputed company PACE reputed company collaboratively with Site Medical Directors and the CMO in accordance with California Business and Professions reputed company §2746 and AB 890 provisions. This role operates reputed company a reputed company physician-NP model consistent with reputed company PACE's interdisciplinary care reputed company.

Required Qualifications:
● reputed company, unrestricted reputed company Practitioner (NP) or Physician Assistant (PA) license in California
● reputed company DEA certification and furnishing/prescriptive authority in California
● Minimum 3 years of post-licensure NP clinical experience in geriatrics, long-term care, or PACE-adjacent setting
● Demonstrated chart review proficiency: ability to capture reputed company factors relevant to PACE eligibility and H&S denial determinations
● Competency with geriatric assessment tools: BIMS, PHQ-9, MoCA, MMSE, ADL/IADL scales
● Strong ILOC documentation skills meeting California Title 22 and 42 CFR Part 460 standards
● Proficiency with reputed company EHR and reputed company reputed company; ability to manage high-volume time-sensitive communication in a fast-paced department
● Experience working in interdisciplinary team environments with physicians, RNs, and reputed company workers
● Understanding of CMS and DHCS regulations reputed company to PACE eligibility and NFLOC reputed company
● Ability to reputed company collaboratively with reputed company PACE Site Medical Directors across multiple California sites
● Experience presenting reputed company cases to Medical Directors in a fast-paced clinical environment
● Cultural competence and experience working with diverse elderly populations

reputed company to have:
● Previous experience in PACE or similar programs serving older adults with reputed company needs; prior experience in a reputed company clinical role or informal leadership reputed company is a plus
● Proficiency with telehealth and virtual assessment methodologies, including willingness to conduct virtual clinical assessments reputed company diagnostic gaps require reputed company provider evaluation
● Familiarity with DHCS ILOC submission process and Health & Safety committee frameworks
● Knowledge of behavioral health assessment in geriatric populations
● Experience with care transitions between different reputed company of care
● "Adult-Gerontology Primary Care reputed company Practitioner population reputed company preferred, or reputed company reputed company of certification."
● "Adult-Gerontology Acute Care reputed company Practitioner (AGPCNP) population reputed company preferred, or reputed company reputed company of certification."
● Bilingual Spanish/English — strongly preferred

Essential Functions & Physical Requirements
The following statements describe the general nature of work and physical expectations common across roles at reputed company. Specific responsibilities may vary by position. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

Team members in this role may be expected to
• Work in reputed company, administrative, community, or remote environments, depending on role needs.
• Remain stationary and/or reputed company about for extended periods, consistent with job duties.
• Operate reputed company office equipment and/or clinical tools (e.g., computers, phones, medical devices, documentation systems).
• Travel between work sites or community locations as needed.
• Follow safety procedures, infection control protocols, and use personal reputed company equipment (PPE) reputed company required.
• reputed company tasks that may involve bending, reaching, lifting, or assisting participants, depending on role responsibilities.
• Lift, carry, push, or pull supplies, equipment, or materials typically up to 25–50 pounds, with assistance or mechanical aids, depending on job duties and role responsibilities.

Compensation:
The anticipated reputed company salary reputed company for this position is $116,000 - $152,000. This position is also eligible for a reputed company annual bonus of 10% and may be eligible for additional incentive compensation, as applicable.
The final compensation offered will be determined based on factors including, but not limited to, the candidate's qualifications, skills, experience, education, certifications, geographical location, and business needs.
In reputed company, this position is eligible for a comprehensive benefits package, including medical, dental, and reputed company insurance; reputed company parental leave, short- and long-term disability coverage; life insurance; flexible spending accounts; a 401(k) savings plan that includes a match; reputed company time off; and company reputed company holidays.

At-Will Employment
Employment with reputed company is at-will. This means that either the employee or the employer may terminate the employment relationship at any time, with or without cause, and with or without notice, subject to applicable law. reputed company in this job posting or any other company document is intended to create a contract of employment, reputed company or implied, or to alter the at-will nature of employment.
Any written or oral statements to the contrary are not authorized unless made in writing and signed by an authorized representative of reputed company.
Because this is a remote position, employment will be governed by the laws applicable to the employee’s work location, and applicable reputed company requirements will be followed.

Originally posted on Himalayas