EDUCATION AND EXPERIENCE:
Doctorate Degree required
Essential Job Functions:
- Treating patients in CCRCs, including independent living, assisted living, long term nursing care, memory units, and skilled nursing care.
- Obtaining and recording a detailed medical history of each patient, using independent historians as needed;
- Performing complete physical exams and review of systems, and documenting findings in the electronic medical record;
- Assessing the medical conditions of each patient, utilizing external testing results and performing additional testing to support the associated diagnoses and plan of care;
- Referring patients to other physicians, including specialists and other health care providers, when necessary;
- Prescribing medication and treatment for the patient and recommending appropriate physical and dietary routines to support their health;
- Coordinate and collaborate with CCRC staff to ensure the plan of care is implemented and the needs of the patients are met;
- Keeping and maintaining electronic patient medical records related to all processional services rendered, locking notes in a timely manner, and billing for all services rendered.
- Review and attend to all external reports and correspondence pertaining to the patient’s plan of care.
- Participating in discharge planning from CCRCs, collaborating with the facilities, families, and available resources to improve transitions of care;
- Providing coverage when other physicians are unavailable due to vacations, illness or attendance at professional conferences; includes rotation in on-call coverage for evenings, weekends, and holidays.
- Reporting births, deaths, outbreak of contagious diseases, and other information required in a timely manner to appropriate governmental authorities and as required for TriValley reporting.
- Advanced Care and End of Life Planning with patients, families and caregivers.
- Maintain licensure and board certification; attending continuing medical education as required.
- Promoting the professional practice of TriValley Primary Care and its affiliates.
- Active participation in Value Based Contracts, including addressing specified quality metrics, monitoring patients’ costs and utilization, engagement with comprehensive care management, and accurately coding and appropriately assessing patients’ full medical complexity;
- Participation in strategic meetings and planning sessions for value based contracts as they pertain to the CCRC population.
- Performing other duties assigned by TriValley from time to time that are commensurate with the professional services normally and customarily performed by a primary care physician.
Key Decisions:
- Establishing a plan of care appropriate for each patient’s conditions and available supports;
- When to refer patients to specialists or other health care providers or facilities for additional care;
- When to discharge patients to their community residence.
Key Result Areas/Results Expected:
- Provide excellent care to patients residing in CCRCs;
- Accurately document the full complexity of the patients’ medical conditions;
- Accurately document and bill for all services rendered;
- Ensure length of stay is appropriate for the medical complexity of each patient;
- Manage hospital readmission risk for patient panel.
Minimum Qualifications:
Education and Formal Training: Holds a current Pennsylvania license as an MD or DO; Board Certified in Family Medicine, Internal Medicine or Geriatric Medicine.
Work Experience: Prefer two years’ work experience in CCRCs.
Other Specific Knowledge, Skills, or Abilities: Ability to engage family and care givers in patients’ plan of care; collaborative communication skills with CCRCs.
Physical Demands:
Sensory Requirements: Needs manual dexterity, visual and hearing acuity; and ability to speak.
Work Environment:
Hazards: Medical setting with potential risk of exposure to communicable diseases.
Discomforts: Stress level: Moderate
Contacts: Patients, nursing staff, facility administration, TVPC Shareholders, Practice Administrator, and other support staff. Also contact with external parties and advisors.
Special Privacy or Security Concerns: Maintain privacy of confidential meetings and financial records.
LICENSES AND CERTIFICATIONS:
Physician – Licensed, Upon hire, required