Primary Care Provider - National Traveler

Job Summary

Deliver primary care and continuous healthcare services to PACE participants, assessing, planning, and providing care in alignment with PACE Program standards. Works closely with the clinical care team and collaborates with the Medical Director to manage referrals and develop care plans.

Essential Duties and Responsibilities

• Provide high-quality primary care with a focus on individualized evaluation, including comprehensive history and physical exams.
• Collaborate with the IDT to ensure referrals are necessary and maintain continuity of care.
• Manage and monitor participants' medications, aiming for accurate reconciliation and communication with the collaborating pharmacist.
• Stay informed of participant status during hospitalizations and facility stays, providing appropriate guidance and ensuring care continuity.
• Assume shared responsibility for all participants, supporting the IDT model of team-based care and participating in daily IDT meetings.
• Accurately document assessments and participant care plans, ensuring compliance with policy, regulatory, and quality standards.
• Respond to labs, imaging, and consults promptly, incorporating findings into ongoing care plans and communicating changes to the IDT.
• Educate participants and caregivers on self-care strategies, medication use, and wellness practices.
• Use the Emergency Department judiciously, prioritizing PACE resources unless symptoms are potentially life-threatening.
• Accurately document diagnoses with proper coding practices, supporting risk adjustment and quality reporting metrics.
• Provide coverage for the 24/7 on-call rotation, addressing participant needs promptly and ensuring proper hand-offs and communication.
• Contribute to discharge planning and support smooth transitions across care settings.
• Assist with staff training and mentoring, contributing to clinical policy development and best practice implementation.
• Participate in ongoing performance and quality improvement initiatives.
• Step into other roles as needed to support the team, maintaining clinical resource needs and reporting to the Medical Director.

Experience and Education

• MD, DO, APRN, NP, or PA
• Current State license
• CDS Certification and DEA Registration
• BLS required (within 90 days of employment)
• 2 years experience providing direct patient care (preferred)
• 1 year of experience working with a frail or elderly population (preferred)

Pre-Employment Requirements

• Reliable transportation, valid driver's license, and minimum state required liability auto insurance
• Medical clearance for communicable diseases and up-to-date immunizations