Nurse Practitioner - Academic Home Based Primary Care Program

Carlisle, NY, United States

Department/Unit:

PCI - Internal Medicine

Work Shift:

Day (United States of America)

Salary Range:

$0.00 - $0.00Position Summary
We are seeking a dedicated and compassionate Nurse Practitioner (NP) to join our academic home-based primary care practice, serving approximately 200 homebound older adults across an 11-county region in the Greater New York Capital Region. This position will work in close collaboration with a full-time board-certified geriatrician to provide comprehensive, longitudinal care to medically complex, homebound patients.The NP will manage a personal panel of approximately 40 patients and provide cross-coverage for an additional 160 patients in the practice. The role includes home visits, telehealth support, and the management of chronic and acute medical conditions, with a strong emphasis on geriatric syndromes, care coordination, and diagnostic oversight.

Essential Duties and Responsibilities

Clinical Care:

• Provide primary care services to a panel of ~40 homebound patients through in-person home visits and virtual encounters as appropriate.
• Collaborate closely with the geriatrician to co-manage patient care across the full practice panel (~200 patients).
• Cross-cover the remaining 160 patients, including addressing urgent clinical needs, medication adjustments, and patient/caregiver inquiries.
• Conduct comprehensive assessments and develop individualized care plans that reflect patients' goals, preferences, and functional status.
• Manage acute and chronic conditions, focusing on geriatric syndromes (e.g., falls, dementia, polypharmacy, frailty).
• Coordinate with caregivers, visiting nurses, specialists, and other home-based service providers.
• Provide palliative and end-of-life care consistent with best practices and patient wishes.

Diagnostic & Lab Oversight:

• Order and interpret laboratory tests, imaging, and other diagnostic studies.
• Track and review results for the entire patient population in collaboration with the geriatrician.
• Ensure timely communication of clinically significant findings and follow-up planning.

Team Collaboration & Communication:

• Participate in regular team meetings and interdisciplinary case conferences.
• Maintain thorough, accurate documentation in the electronic medical record (EMR).
• Educate patients and caregivers regarding health conditions, medications, and treatment options.
• Contribute to quality improvement and academic initiatives within the practice.

Qualifications

Required:

• Master's or Doctorate degree from an accredited Nurse Practitioner program
• Current NY State NP license and board certification (Adult-Gerontology Primary Care or Family NP)
• DEA license and BLS certification
• Minimum of 2 years of experience in primary care, geriatrics, or home-based care
• Valid driver’s license and reliable transportation for home visits

Preferred:

• Experience with home visits and medically complex, frail older adults
• Prior experience in academic or teaching settings
• Familiarity with value-based care models and interdisciplinary care approaches

Skills & Competencies

• Strong clinical judgment and autonomous decision-making capability
• Excellent interpersonal and communication skills with patients, families, and care teams
• Ability to manage a large panel and track results for a broad patient population
• Comfortable with mobile technology, EMRs, and virtual communication tools
• Compassionate, patient-centered, and team-oriented

Working Conditions

• Home visits required across urban, suburban, and rural areas in an 11-county region (travel reimbursed)
• Flexible schedule with support for remote administrative work
• Participation in a collaborative academic environment with opportunities for teaching and quality improvement

Thank you for your interest in Albany Medical Center!

Albany Medical Center is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Thank you for your interest in Albany Medical Center!​

Albany Medical is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.