Primary Care Physician

AbsoluteCare; Maryland; On-site; USD 180,000 - 240,000; Full time

Job summary

AbsoluteCare in Maryland is seeking a physician specialized in Internal Medicine or Family Practice to lead care for patients with multiple chronic conditions. You will work within a team including social work, case management, behavioral health, pharmacy, and nutrition to coordinate comprehensive plans.

You will develop transitional care plans across hospital, ER, SNFs, and home care, facilitate safe discharges, manage acute exacerbations, and ensure timely urgent appointments.

Qualifications

• Licensed Physician in the state of Practice.
• Board certified in Internal Medicine or Family Practice.
• BLS certification required.
• Mission-driven to serve the underserved.
• Work without ego, and thoughtfully build successful relationships with team members and our partners.
• Experience using EMR systems.
• Problem-solving and creative thinking.

Responsibilities

• Manage health outcomes for patients with multiple complex chronic conditions.
• Lead a multidisciplinary team and implement care plans.
• Develop transitional care plans across hospital, ER, SNFs and home care.
• Coordinate with inpatient and post-acute facilities for safe discharges.
• Address acute exacerbations with appropriate interventions.
• Schedule urgent/next-day visits for high-need patients.
• Monitor patients to prevent ER visits, admissions, and readmissions.
• Apply PCMH principles to specialist and primary care.
• Educate patients on chronic disease progression and advanced directives.
• Practice evidence-based medicine per PCMH model.

Job description

• Focuses on the management and improvement of health for patients with multiple complex and chronic medical conditions.
• Able to work with and lead a team (with social work, case management, behavioral health, pharmacy, nutrition, etc.), process feedback, and be open to discussing and implementing plans of care from other members of the team.
• Develop strong transitional care plans and able to help keep track of paneled patients along the whole continuum of care including discharges from the hospital, ER, skilled nursing facilities/nursing homes, and home care.
• Communicate and interact with alternate levels of care facilities (hospital, ER, skilled nursing facilities) to facilitate appropriate discharge to a lower level of care or back to the AbsoluteCare Medical Center. Familiar with inpatient medicine and the discharge process to help facilitate discharges.
• Treat acute exacerbations of chronic conditions within the AbsoluteCare center, i.e. Lasix for CHF, IVF for Dehydration/Renal Failure, IV antibiotics for various infections, Nebulizer/Solumedrol for COPD/Asthma etc. Possess a comfort level and the knowledge to differentiate when exacerbation can be treated within AbsoluteCare and when a higher level of care needed.
• Accept same day/next day or urgent appointments for patients from home or discharged from the hospital/ER/skilled nursing facility in need of intensified physician or case management/social work services to ensure acute episode has resolved and the patient is not admitted/readmitted.
• Vigilant in keeping track of patients and their disease processes to prevent ER visits, admissions to the hospital, and readmissions.
• Understand the PCMH model of care as pertains to specialist care, only utilizing this higher level of care as needed, and not a substitute for a well-trained primary care physician with evidence based clinical skills.
• Educate members on chronic disease progression and the need for advanced directives where applicable.
• Practices evidenced based medicine and in accordance with the PCMH model of care.

Specific Duties And Responsibilities

Complex Clinical Care:

• Focuses on the management and improvement of health for patients with multiple complex and chronic medical conditions.
• Able to work with and lead a team (with social work, case management, behavioral health, pharmacy, nutrition, etc.), process feedback, and be open to discussing and implementing plans of care from other members of the team.
• Develop strong transitional care plans and able to help keep track of paneled patients along the whole continuum of care including discharges from the hospital, ER, skilled nursing facilities/nursing homes, and home care.
• Communicate and interact with alternate levels of care facilities (hospital, ER, skilled nursing facilities) to facilitate appropriate discharge to a lower level of care or back to the AbsoluteCare Medical Center. Familiar with inpatient medicine and the discharge process to help facilitate discharges.
• Treat acute exacerbations of chronic conditions within the AbsoluteCare center, i.e. Lasix for CHF, IVF for Dehydration/Renal Failure, IV antibiotics for various infections, Nebulizer/Solumedrol for COPD/Asthma etc. Possess a comfort level and the knowledge to differentiate when exacerbation can be treated within AbsoluteCare and when a higher level of care needed.
• Accept same day/next day or urgent appointments for patients from home or discharged from the hospital/ER/skilled nursing facility in need of intensified physician or case management/social work services to ensure acute episode has resolved and the patient is not admitted/readmitted.
• Vigilant in keeping track of patients and their disease processes to prevent ER visits, admissions to the hospital, and readmissions.
• Understand the PCMH model of care as pertains to specialist care, only utilizing this higher level of care as needed, and not a substitute for a well-trained primary care physician with evidence based clinical skills.
• Educate members on chronic disease progression and the need for advanced directives where applicable.
• Practices evidenced based medicine and in accordance with the PCMH model of care.

Candidate Qualifications

• Licensed Physician in the state of Practice
• Board certified in Internal Medicine or Family Practice
• BLS certification required
• Mission-Driven to serve the underserved
• Work without ego, and thoughtfully build successful relationships with team members and our partners
• Ability to work as part of a multidisciplinary team with constant collaboration within and across provider teams
• Experience and comfort utilizing EMR
• Problem-solving and the ability to be creative in those solutions

Preferred Qualifications

• Experience in population health management
• Experience in working with psycho-socially and medically complex patient population