Job Description
Job Description
Position : Nurse Practitioner- Post Transplant
Location : Sacramento, California
Schedule : Full-time, Monday–Friday
About the Organization
We are a purpose-driven healthcare provider focused on delivering compassionate, coordinated care to older adults and high-risk populations across underserved communities. Our care model is proactive, value-based, and clinician-led, emphasizing outcomes over volume and patient trust over transactional medicine.
Working across a network of primary care practices and health plan partnerships, we aim to improve access, reduce unnecessary hospital utilization, and ensure a high-touch experience for every patient we serve.
About the Role
This full-time Nurse Practitioner opportunity centers around long-term, post-transplant care — specifically for kidney recipients one year or more after transplantation. The role involves a mix of in-clinic and in-home visits across the Sacramento region, focused on chronic condition management, immunosuppressive regimen oversight, and improving long-term graft and patient outcomes.
This is an excellent opportunity for a skilled and detail-oriented NP passionate about continuity care, interdisciplinary collaboration, and supporting patients in navigating complex health conditions outside of traditional hospital systems.
Key Responsibilities
Clinical Care & Coordination
- Manage ongoing care for patients one year or more post-kidney transplant
- Perform follow-up visits to assess transplant function, monitor labs, adjust medication, and educate patients on health maintenance
- Identify and escalate signs of graft dysfunction, infection, or medication-related complications
- Provide chronic disease management, particularly for conditions like hypertension, diabetes, and cardiovascular risk
- Adjust immunosuppressive therapy as appropriate and in coordination with consulting nephrologists
- Conduct routine screenings, provide vaccinations, and support preventive care plans
- Complete thorough, timely clinical documentation aligned with regulatory standards
Interdisciplinary Collaboration
Work alongside transplant specialists, PCPs, case managers, and social workers to ensure a cohesive, whole-person care approachActively contribute to care plan meetings and communicate treatment goals and progressParticipate in peer reviews, quality improvement efforts, and ongoing patient outcome initiativesPatient Experience & Education
Build long-term relationships with patients and caregivers through in-home and clinic-based interactionsEducate patients and their support systems on post-transplant lifestyle adjustments, medication adherence, and care goalsSupport high-risk patients during care transitions with personalized follow-ups and care navigationServe as a clinical quarterback, proactively coordinating care needs across specialtiesAdministrative & Compliance
Maintain HIPAA-compliant records and safeguard patient privacy at all timesComplete documentation and coding accurately, particularly for Medicare populations and HCC guidelinesFlex across assigned regions as needed to meet changing patient schedules or coverage needsCandidate Profile
Required :
Active Nurse Practitioner license in CaliforniaCertification from ANCC or AANPMinimum 2 years’ experience in nephrology, transplant, or managing complex chronic conditionsDEA license (or willingness to obtain)Current BLS / CPR certificationValid California driver’s license and willingness to conduct home visitsPreferred :
Experience with transplant patients, immunosuppressive protocols, or care transitionsStrong EMR proficiency and comfort with digital documentation workflowsBilingual Spanish skills a plusAttributes for Success :
Patient-focused and naturally collaborativeAnalytical thinker who thrives in clinical autonomy and interdisciplinary teamworkComfortable with high-acuity patients and long-term care planningDetail-oriented with strong time management and follow-throughCommitted to professional growth, evidence-based care, and improving patient outcomesBenefits & Compensation
Annual Salary : $145,000 – $160,000Full health benefits including medical, dental, and vision plansHealth Savings and Flexible Spending Accounts401(k) with employer matchGenerous PTO, paid holidays, and parental leaveMonthly phone and internet stipendAccess to mental health support and wellness reimbursementLicense, certification, and CE reimbursementCompany-paid malpractice coverageSupportive peer community of advanced practice providersCommitment to Inclusion
We are committed to fostering a welcoming, inclusive workplace for individuals of all backgrounds. If you’re passionate about expanding access to high-quality care—even if you don’t meet every qualification listed—we encourage you to apply.