At UpStream, we are dedicated to promoting good health and empowering individuals to lead independent lives. As a trusted partner to primary care physicians, we offer effective and sustainable care options, focusing on seniors and those with chronic conditions. Our comprehensive solution allows physicians to prioritize patient care while our value-based care model ensures effective condition management.

We prioritize affordability and accessibility, collaborating with healthcare practices and clinics to reduce costs and enhance system efficiency. Through personalized care plans and innovative solutions, we strive to improve health outcomes and enable patients to live fulfilling, independent lives.

How you’ll help

As a Clinical Performance and Accountability Nurse Practitioner, you will be responsible for reviewing hospitalization records, analyzing utilization patterns, and developing strategies to reduce hospitalization rates. You will work closely with care teams comprised of pharmacists, nurses and medical assistants, as well as other stakeholders to ensure the efficient and effective/appropriate utilization of healthcare resources while maintaining the highest standards of patient care.

What you'll do

Review Hospitalization Records: Thoroughly review and analyze hospitalization records to identify trends and patterns in utilization. This includes evaluating the appropriateness of hospital admissions and identifying potential areas for improvement.
Utilization Pattern Analysis: Conduct in-depth analysis of utilization patterns, including readmission rates, length of stay, and resource utilization. Identify factors contributing to high utilization and areas of improvement.
Collaborate with Care Teams: Collaborate with clinical pharmacists, nurses, and care teams to provide insights and feedback on utilization patterns. Act as a resource for clinical staff to optimize patient care plans and reduce unnecessary hospitalizations.
Develop Strategies: Develop and implement strategies to reduce hospitalization rates, improve patient outcomes, and enhance the quality of care. This may include the development of care protocols, patient education programs, and utilization review processes.
Data Management: Maintain accurate and up-to-date records of utilization data and outcomes. Use data analytics tools and electronic health records (EHR) systems to track and report on key performance indicators.
Education and Training: Provide education and training to clinical staff on best practices for reducing hospitalizations and improving patient care. Stay updated on the latest healthcare trends and guidelines.
Quality Assurance: Monitor and assess the impact of implemented strategies on hospitalization rates and patient outcomes. Continuously evaluate and adjust strategies to ensure effectiveness.
Reporting: Prepare regular reports and presentations on utilization patterns, strategies, and outcomes for presentation to senior management and stakeholders.

What you'll need:

Master's degree in Nursing (MSN) and certification as a Nurse Practitioner (NP)
Active and unrestricted Nurse Practitioner license in North Carolina
Minimum of 5 years of clinical experience as a Nurse Practitioner within primary care or as hospitalist
Strong analytical and data analysis skills
Excellent communication and interpersonal skills
Knowledge of healthcare regulations and compliance standards
Experience in healthcare quality improvement and utilization management is a plus
Proficiency in electronic health records (EHR) and data analytics tools
Nursing administrative experience
Clinical hospitalist experience is preferred
Experience training and mentoring preferred

At UpStream we offer a range of benefits to ensure our employees are taken care of. Our health insurance plans through United Health Care include FSA and HSA options, and we also offer dental, vision, life, and accident coverage through Guardian. We immediately match contributions to our 401k plan, which includes both Roth and Traditional options. In addition, we provide financial perks and rewards through BenefitHub, and free access to EAP services through WorkLifeMatters. Our employees also enjoy generous PTO and paid holidays.

We value diversity and promote equal opportunities for all. As an equal opportunity employer, we do not discriminate against applicants based on their race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. All qualified candidates are encouraged to apply.

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