Mount Sinai Palliative Care at Home Program is a community-based palliative care program for adults with serious illness and their caregivers offered by a unique company co-owned by Mount Sinai and Contessa Health.  It provides coordinated, high quality, in-home palliative care to patients with advanced life-limiting illness and their caregivers. Patients will be eligible to enroll in the program if they live in areas that Mount Sinai services and have an advanced life-limiting illness and have needs which could be addressed by the program.  

The full clinical team is comprised of community health workers, nurse practitioners, nurses, social workers and physicians. The clinical team will work in collaboration with patients’ other healthcare providers to provide high quality, evidence-based palliative care in patients’ homes, supported by robust guidelines and care processes. Mount Sinai’s other home-based services, such as Hospitalization at Home, all work to support patients and caregivers in their homes.  Additionally, this program is supported by the breadth of all Mount Sinai’s care settings, including its physician practices and outpatient services.

The program is designed to improve symptoms and quality of life, reduce caregiver burden, and reduce unnecessary hospitalizations and ED visits.

Nurse Practitioner Role Description

We are seeking to recruit a dynamic and enthusiastic full-time nurse practitioner (NP) to work within the Mount Sinai Palliative Care at Home team. The NP will have both direct clinical responsibilities and act in a supervisory capacity to the nurses and CHWs within the team. Their responsibilities will include:

• Initiating advanced care planning discussions, documenting goals of care/completing advance directives and creating care plans where treatments are matched to goals
• Communicating with primary clinicians, informing them of the plan of care and negotiating treatments and goals of care
• Leading oversight of care plans in conjunction with the rest of the clinical care team
• Assessing & managing complex/urgent cases, both in-person, through telehealth and via telephone
• Conducting in-home and telehealth primary or urgent assessments for patients with complex needs, including formulating a likely diagnosis (through history and examination), ordering investigations, and delivering appropriate care in line with patient’s preferences and goals for care
• Advocating for the patient and caregiver in collaborating with other care providers to keep care is coordinated and consistent with patient’s goals
• Prescribing new medications and medication reconciliation
• Leading the weekly IDT meeting that may include physicians, nurses and other members of the care team

Expected working hours will be Monday through Friday 8:00 AM to 5:00 PM with potential for on-call as a secondary patient resource

• Bachelor’s degree
• Master’s degree in Nursing, Health Science, or Medical Science

Licensing

• Licensed as a nurse practitioner

Certification (or equivalent experience)

• Advanced palliative care certification encouraged (e.g. Advance Certification in Hospice and Palliative Nursing from Hospice and Palliative Credentialing Center (HPCC))

Essential Skills / Experience

• Minimum of 3 years of palliative care/hospice experience
• Experience working in an interdisciplinary team
• Clinical assessment skills – including history taking, examination, ordering appropriate diagnostic testing
• Competence in prescribing medications for symptom management and de-prescribing medications as necessary  
• Competence in management of problems experienced by patients with life-limiting illness
• Excellent communication, teamwork, and leadership skills
• Working in electronic medical records

Desirable Skills / Experience

• Home care experience
• Advanced communication skills
• CPR certification, ACLS certification