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Advanced Practice Provider - Pittsburgh East area

Highmark Inc

  • PA
  • 11 days ago

    Highlights

    The role proactively manages symptoms, guides advance care planning, and supports members with chronic or life-limiting illnesses to ensure optimal quality of life and health outcomes. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
    Highmark Inc

    Numbers & Facts

    LocationPA
    IndustryHealthcare Services
    Company Size1,000 to 1,499 employees
    Year Founded1996
    Websitehttps://www.highmark.com/hmk2/index.shtml

    Description

    Apply for Advanced Practice Provider - Pittsburgh East area | Careers at Highmark Health Skip to main content

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    Clinical Services

    Advanced Practice Provider - Pittsburgh East area

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    Advanced Practice Provider - Pittsburgh East area

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    • Work At Home - Pennsylvania, HOME PA 90001, United States
    • Remote

    Company :

    Endorsed

    Job Description :

    JOB SUMMARY

    This role is integral to the organization"s comprehensive care delivery system. The incumbent delivers high-quality, patient-centered care through in-home, virtual, and telephonic comprehensive clinical assessments for members with chronic health conditions. This autonomous position provides holistic, community-based care, especially for geriatric and palliative populations. The role proactively manages symptoms, guides advance care planning, and supports members with chronic or life-limiting illnesses to ensure optimal quality of life and health outcomes. The role involves accurately identifying and documenting all active chronic medical conditions essential for risk adjustment.

    ESSENTIAL RESPONSIBILITIES

    • Comprehensive Clinical Assessments: Conduct comprehensive in-home, video, and telephonic clinical assessments, including detailed histories, physical examinations, and identification of all active diagnoses, symptoms, functional status, and social determinants of health.

    • Diagnostic Interpretation & Treatment Planning: Order and interpret laboratory, radiological, and other diagnostic studies, then make medical diagnoses and institute appropriate therapy within applicable scope and standards of practice.

    • Palliative Care & Symptom Management: Manage medications and treatments related to palliative care, alleviating pain and other distressing symptoms related to life-limiting illnesses.

    • Patient & Family Guidance: Provide emotional and psychological support, and educate patients and families about illness progression, treatment options, and aligning to goals of care.

    • Advance Care Planning: Facilitate advance care planning conversations and end-of-life discussions.

    • Collaborative Care Coordination: Collaborate and coordinate care with other providers active on the patient"s care team and participate in interdisciplinary team meetings to review and update patient care plans.

    • Emergency Intervention: Institute emergency measures or appropriate stabilization for acute patient situations.

    • EMR & Risk Adjustment Documentation: Utilize electronic medical record (EMR) systems for thorough and compliant clinical documentation, ensuring timely and accurate record of pertinent information to support comprehensive medical coding and risk adjustment methodologies.

    • Reporting & Communication: Identify and inform the attending physician of record of all significant changes to the patient"s ongoing condition in a timely manner.

    • Professional Development & Compliance: Maintain mandatory professional continuing education and uphold professional practice consistent with organizational statements and medical staff compliance.

    • Other duties as assigned or requested.

    EDUCATION

    Required

    • Graduate from an accredited PA program OR Graduate from a Nursing Approved Master's or Post Master's program

    Substitutions

    • None

    Preferred

    • Board certification or clinical experience in a relevant specialty (e.g., Family Medicine, Internal Medicine, Geriatrics, Hospice or Palliative Care).

    EXPERIENCE

    Required

    • 3 years of clinical experience as an NP or PA, preferably in primary care, geriatrics, palliative or hospice care, chronic disease management, home health, or a similar community-based setting.

    Preferred

    • Previous experience conducting in-home assessments or house calls.

    • Knowledge of CMS regulations and guidelines.

    • Experience in population health management.

    LICENSES or CERTIFICATIONS

    Required

    • Current Physician Assistant License OR Current State of PA RN licensure or Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) + CRNP license and Prescriptive Authority in the State of PA.

    Preferred

    • DEA controlled substances license

    SKILLS

    • Patient & Family Engagement: Exceptional communication, motivational interviewing and empathy skills for patient-centered care, sensitive health discussions, and effective education for diverse patient populations.

    • Clinical Acumen & Care Planning: Expertise in critical clinical assessment and the ability to identify and address patient care gaps, opportunities for health improvement and formulate care plans including advance care planning.

    • Interpersonal & Team Collaboration: Exceptional interpersonal and communication skills to build rapport and effectively collaborate with internal and external care teams.

    • Autonomous Work & Caseload Management: Demonstrated ability to work autonomously and manage an effective caseload in a community-based or home care setting.

    • Organizational & Time Management: Excellent organizational and time management skills to efficiently conduct multiple visits daily and complete documentation.

    • Problem-Solving & Adaptability: Strong problem-solving skills and the ability to adapt to unexpected situations in the field.

    • Technological Fluency: Proficient with EMR systems, portable diagnostic equipment, mobile technology, and standard computer applications including Microsoft Office products.

    • Continuous Learning: Commitment to continuous learning and professional development, particularly in palliative care, geriatrics, risk adjustment, and clinical guidelines.

    • Risk Adjustment & Documentation Acumen: Strong knowledge of risk adjustment methodologies and coding principles, coupled with the ability to ensure documentation integrity for compliant medical coding.

    • High-Performing Team Integration: Ability to work effectively in a flexible, high-performing team environment.

    Language (Other than English):

    None

    Travel Requirement:

    50% - 75%

    PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

    Position Type

    Office-based

    Teaches / trains others regularly

    Occasionally

    Travel regularly from the office to various work sites or from site-to-site

    Occasionally

    Works primarily out-of-the office selling products/services (sales employees)

    Never

    Physical work site required

    Yes

    Lifting: up to 10 pounds

    Constantly

    Lifting: 10 to 25 pounds

    Rarely

    Lifting: 25 to 50 pounds

    Never

    Exposure to Blood, body fluids or tissue

    Occasionally

    Exposure to needles or sharps

    Occasionally

    Additional Employment Requirements:

    • Valid driver"s license and reliable transportation with appropriate insurance coverage to travel to patient homes across designated service areas.

    • CPR Certification

    Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

    Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

    As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

    Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

    Pay Range Minimum:

    $102,700.00

    Pay Range Maximum:

    $164,600.00

    Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

    Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

    We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

    For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

    California Consumer Privacy Act Employees, Contractors, and Applicants Notice

    Recruitment Fraud Alert

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    Job Details

    • Job category Clinical Services

    • Position Type Full Time

    • Posted 09/30/2026

    • Location(s)

    • Work At Home - Pennsylvania, HOME PA 90001, United States

    • Remote

    • Line of Business

    • Entity

    • Recruiter

    • Hiring Manager

    • Experience Level

    • Job Family Clinical Gen-HM

    • Req ID J287744

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    Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

    Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

    We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

    We provide reasonable accommodations to applicants with disabilities or who require accommodations for sincerely held religious beliefs or for known limitations related to pregnancy, childbirth, or related medical conditions. If you need an accommodation, please contact HRServices@highmarkhealth.org. This email is exclusively for accommodation requests under applicable laws.

    2026 Highmark Health. All Rights Reserved.

    About Company

    Highmark provides millions of people with the security of quality health insurance

    Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.

    Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.

    Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

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