Nurse Practitioner: Risk Adjustment

Primary Duties And Responsibilities

• The Nurse Practitioner provides high quality advanced nursing care in accordance with professional regulatory standards and within the scope of the nurse practitioner license. This role provides multidisciplinary care providing patient evaluations and assessments, patient education, interventions, and documents plan of care. Requests physician consultations and multidisciplinary consults. Recognizes that ethical/legal/medical dilemmas exist in the nursing practice, and confers with the appropriate resources and staff when making ethical decisions. May work as an independent provider and/or under indirect supervision of a supervising physician. May see all and treat a variety of age populations.
• Depending on area, may work different hours, weekends and holidays. May require on-call time.
• Privileges granted by the Medical Staff Department can include arranging admission and transfer of patients, performing and dictating exams, history and physicals, rounding on assigned patients and writing progress notes with plan of care, and dictating discharge summary. Also may furnish medications (non-narcotic) and durable medical equipment (DME), controlled substances III, IV, V with appropriate licensure/certification, and controlled substances II with appropriate licensure/certification. May order blood products, laboratory tests, radiological, ultrasound, nuclear medicine, and neurological studies, oxygen therapy, respiratory treatment, and pulmonary tests. May perform drain and suture removal. May order and administer medications and IV therapy with the ability to assess and adjust appropriate dosing.
• Risk Adjustment: In addition to the above, the Risk Adjustment Nurse Practitioner is responsible for the execution of guided processes to complete Annual Health Assessments “AHAs” for Hoag Clinic’s Medicare patient population.  Works with patients with chronic illnesses commonly encountered in the adult and geriatric patient population. Responsible for assessment, diagnosis, education, health promotion, and care coordination for patients with acute and chronic health needs. In addition, must have advanced knowledge of HCC Coding and Documentation, and Quality Measure guidelines.
• Performs other duties as assigned.

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ [https://www.hoag.org/about-hoag/awards-accreditations/].

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.