Central Pre-Enrollment Provider Nurse Practitioner

About this role

Habitat Health empowers older adults to experience more good days in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, and in ‑ home assistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and complex needs of aging populations, our mission ‑ driven care teams continue to help participants live well on their own terms.

Habitat Health is supported by leading healthcare organizations and investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a better model of care for older adults. To learn more, visit www.habitathealth.com.

Role Scope : We are looking for clinically outstanding clinician and detail-oriented Nurse Practitioner or Physician Assistant to join our centralized Pre-Enrollment team. This role reports directly to the Chief Medical Officer, with a dotted-line relationship to the Pre-Enrollment Director. You will serve as the clinical backbone of our chart review process, working hand in hand with Site Medical Directors across all Habitat Health PACE locations to ensure every case is thoroughly evaluated for PACE eligibility and Health & Safety (H&S) considerations before enrollment.

Estimated Start Date: 9/8/2026

Location: Remote

Core Responsibilities & Expectations for the Role: ● 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

California NP Practice Note: Nurse Practitioners at Habitat Health PACE practice collaboratively with Site Medical Directors and the CMO in accordance with California Business and Professions Code §2746 and AB 890 provisions. This role operates within a collaborative physician-NP model consistent with Habitat Health PACE's interdisciplinary care framework.

Required Qualifications: ● 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

Nice to have: ● Previous experience in PACE or similar programs serving older adults with complex needs; prior experience in a lead clinical role or informal leadership capacity is a plus ● Proficiency with telehealth and virtual assessment methodologies, including willingness to conduct virtual clinical assessments when diagnostic gaps require direct provider evaluation ● Familiarity with DHCS ILOC submission process and Health & Safety committee frameworks ● Knowledge of behavioral health assessment in geriatric populations ● Experience with care transitions between different levels of care ● "Adult-Gerontology Primary Care Nurse Practitioner population focus preferred, or active pursuit of certification." ● "Adult-Gerontology Acute Care Nurse Practitioner (AGPCNP) population focus preferred, or active pursuit of certification." ● Bilingual Spanish/English — strongly preferred

Essential Functions & Physical Requirements The following statements describe the general nature of work and physical expectations common across roles at Habitat Health. Specific responsibilities may vary by position. Reasonable accommodations may be made to enable i

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