Central Pre-Enrollment Nurse Practitioner

Habitat Health

Nurse Practitioner conducting comprehensive chart reviews for PACE program applicants. Collaborating with medical directors to determine eligibility and ensure high standards of care.

Posted 7/24/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $116,000 - $152,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting thorough chart reviews and clinical assessments to determine PACE eligibility, ensuring compliance with regulatory standards. Proficient in collaborating with interdisciplinary teams and presenting complex cases to support informed decision-making.

Highest-signal resume keywords

Nurse Practitioner LicensePhysician Assistant LicenseDEA CertificationChart Review ProficiencyGeriatric Assessment Tools

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Chart ReviewClinical AssessmentILOC Documentation SkillsGeriatric Assessment ToolsDiagnostic Evaluation

Soft Skills

CollaborationCultural CompetenceCommunication

Tools & Technologies

Epic EHRMicrosoft Outlook

Certifications & Qualifications

Nurse Practitioner License in CaliforniaPhysician Assistant License in CaliforniaDEA Certification

Industry Keywords

PACE EligibilityHealth & Safety DeterminationsCalifornia Title 2242 CFR Part 460CMS RegulationsDHCS Regulations

About the role

Key responsibilities & impact

Conduct thorough and complete chart reviews for PACE applicants, evaluating medical records, diagnostic history, functional status, and clinical documentation to capture all 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 all clinical findings are clearly communicated to support informed eligibility decisions
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 point when ERNs are unable to obtain required diagnostic information
Provide clinical expertise for Health & Safety determinations, including participation in H&S Committee meetings; when 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 clear connections between medical conditions, functional limitations, and PACE services are documented to regulatory standard
Support quality improvement initiatives aimed at maintaining high first-pass DHCS approval rates and reducing documentation deficiencies
Serve as a clinical resource for the Pre-Enrollment team on complex cases, supporting accuracy and thoroughness in ILOC documentation to protect the organization's H&S denial integrity

Requirements

What you’ll need

Current, unrestricted Nurse Practitioner (NP) or Physician Assistant (PA) license in California
Current 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 all 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 Epic EHR and Microsoft Outlook; ability to manage high-volume time-sensitive communication in a fast-paced department
Experience working in interdisciplinary team environments with physicians, RNs, and social workers
Understanding of CMS and DHCS regulations related to PACE eligibility and NFLOC criteria
Ability to practice collaboratively with Habitat Health PACE Site Medical Directors across multiple California sites
Experience presenting complex cases to Medical Directors in a fast-paced clinical environment
Cultural competence and experience working with diverse elderly populations.

Benefits

Comp & perks

medical, dental, and vision insurance
paid parental leave
short- and long-term disability coverage
life insurance
flexible spending accounts
401(k) savings plan that includes a match
paid time off
company paid holidays