The Advanced Practitioner will deliver personalized, compassionate medical care primarily to patients with CKD and/or ESRD/ESKD through comprehensive annual wellness exams conducted both in-home and virtually. Responsibilities also include coordinating care with other providers, maintaining accurate patient records, and implementing evidence-based treatment plans to reduce hospitalizations and maximize patient quality of life.
Requirements summary
Candidates must be bilingual in English and Spanish and hold an active, unrestricted Registered Nurse and Nurse Practitioner or Physician Assistant license, along with board certification and an unrestricted DEA certificate. A minimum of two years of direct patient care experience is required, along with access to transportation and proficiency in computer-based data management.
Monogram Health is seeking compassionate and skilled Advanced Practice Providers (Nurse Practitioners or Physician Assistants) to deliver high‑quality in‑home care to patients living with multiple chronic conditions, including diabetes, hypertension, chronic kidney disease, heart failure, COPD, depression, and other complex health needs.
This role works within an integrated multidisciplinary care team (Clinical, Behavioral Health, Pharmacy, Administrative), establishing long-term patient relationships and providing continuity of care to complex patients in their homes and via telehealth. The Advanced Practice Provider has the opportunity to be part of a value-based, patient-centered care model, providing quality driven managed care with a population health focus.
Highlights
Schedule
Patient visits occur 3-4 days/week in the patients’ home with 1-2 days/week telehealth visits (varies by market)
No on‑call, overnights, weekends, including paid company holidays
30–90-minute visit lengths based on appointment type and patient needs
*All schedule responsibilities may evolve with business needs
Total Rewards
Earn a competitive base salary commensurate with experience and education
Grow your clinical skillset and earn $2,500 for every core and specialty competency you complete
Invest in your longevity with a $5,000 annual anniversary bonus
Maximize your income potential with up to 15% in additional bonuses that will be paid out on a quarterly or annual basis
Start earning bonuses sooner — eligibility begins after just 3 months
From your driveway to the patient’s house, we’ve got you covered with mileage reimbursement.
Support your professional growth and continued education with reimbursement for your CEU/CME expenses.
Because rest matters – 15 PTO days, 7 paid holidays, and 1 floating day to make your own.
Responsibilities
Provide evidence‑based, patient‑focused care that reduces avoidable hospitalizations and improves quality of life directly in the patient’s home
Perform comprehensive assessments, including initial evaluations, annual wellness exams, follow‑ups, acute urgent visits, and post‑discharge visits.
Benefits
Dental insurance
Vision insurance
Medical insurance
Paid holidays
Life insurance
Disability insurance
Paid parental leave
Employee referral program
Mental health support
Flexible spending accounts
Employee assistance program
401k with employer match
Health spending accounts
Flexible vacation time
Educate patients and caregivers on disease management, preventive care, medications, and diagnostic testing
Participate in recurring virtual integrated care team meetings
Engage in quality assurance activities, including audits and documentation reviews, to ensure compliance with state board requirements and clinical best practices
May practice in a variety of care settings beyond the patient’s home, including skilled nursing facilities (SNFs), assisted living facilities (ALFs), hospitals, and other affiliated clinical settings, as applicable.
Perform point-of-care testing (A1C and Spirometry), prescribe medications, order tests, and collaborate with patient’s Monogram physician
Coordinate care with PCPs, specialists, and ancillary services
Complete documentation accurately and in a timely manner
Position requirements
Bilingual (English/Spanish)
Active and unrestricted RN and NP license, or Physician Assistant license
Board certification (NP: ANCC/AANP | PA: NCCPA)
Current and unrestricted DEA certificate, or eligibility to obtain
Minimum of two (2) years of direct patient care experience
Field‑based role requiring travel to patient homes, reliable transportation, valid driver’s license, and auto insurance
BLS certification (supported during onboarding)
Demonstrated initiative and independent, critical thinking, and decision-making skills
Knowledge of and compliance with federal/state regulations (HIPAA, OSHA)
Prior experience with EHR systems (e.g. Athena, Salesforce, Epic)
Previous experience conducting annual wellness or comprehensive visits preferred
Background in managed care, population health, or value‑based care preferred
Benefits
Relocation Bonus - Qualified candidates may be eligible for a comprehensive relation package, which may include assistance with moving expenses, temporary housing, and travel costs, in accordance with company policy.
Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
About monogram health
Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
