Primary Care Physician- Compass PLUS Program

Mass General Brigham; Cambridge (MA); On-site; USD 260,000 - 320,000; Full time

Job summary

Mass General Brigham's Compass PLUS program seeks a primary care physician to provide intensive, home- and community-based outpatient care for a small panel of ~100 patients. You'll serve as the PCP for those fully transitioned into Compass PLUS and collaborate with multidisciplinary teams to coordinate care for high-need individuals.

The role emphasizes relationship-based care delivered outside traditional offices in homes and community settings across the Greater Boston area, with light travel

Qualifications

• Population health mindset and health equity.
• Comfort with collaborative care settings.
• Experience in outpatient high-need environments preferred.
• Ability to work in diverse care settings, including homes and community spaces.
• Eligible for Massachusetts medical license and DEA.

Responsibilities

• Deliver comprehensive outpatient primary care to a small group of high-acuity patients.
• Work with multidisciplinary teams in community and home settings.
• Create and execute personalized care plans addressing medical, behavioral, and social needs.
• Consult with PCPs and teams across the system to manage complex patients.
• Support transitions between inpatient, emergency, and outpatient care.
• Collaborate with patients and teams to improve health outcomes and lower hospital utilization.

Skills

Population health

Collaborative care

Home-based care

Relationship-based care

Education

MD or DO in Internal Medicine or Family Medicine

Job description

About Compass PLUS

Compass PLUS is designed for clinicians who thrive in high-need, outpatient environments. This innovative program supports patients facing complex medical and social challenges, using a hands-on and highly collaborative care approach that prioritizes individual patient needs.

Care is delivered outside traditional offices, with teams-including a Nurse Practitioner, Nurse, and Community Health Worker-working directly in patients' homes or community spaces. Most patients stay connected to their existing PCP, but for those with the greatest needs, the Compass PLUS physician takes over care, aiming to eventually transition them back to standard primary care.

For patients requiring the most intensive support, the Compass PLUS physician becomes their primary provider, focusing on reintegrating them into traditional outpatient care when feasible.

About the Role

This role is ideal for primary care physicians seeking to spend more time with fewer patients-managing a small panel of approximately 100 medically and socially complex individuals. You'll serve as the PCP for those fully transitioned into the Compass PLUS program and consult with other providers caring for high-risk patients. The majority of your work will be conducted in homes and community settings, allowing you to address barriers directly and build strong relationships with patients.

Key Responsibilities

• Deliver comprehensive outpatient primary care to a small group of high-acuity patients, focusing on relationship-based, intensive care

• Work closely with multidisciplinary care teams in community and home settings

• Create and execute personalized care plans that address medical, behavioral, and social needs

• Consult with PCPs and teams across the system, sharing expertise in managing complex patients

• Support transitions between inpatient, emergency, and outpatient care, always with a patient

• Collaborate with patients and teams to improve health outcomes and decrease unnecessary hospital use

Practice Details

• Panel size of about 100 patients enables more dedicated, intensive care

• Care is primarily delivered in homes and community locations-no traditional office visits required

• Work is centered in the Greater Boston area

• Local travel is necessary, with occasional regional trips (1-2 times per month)

• No evening or weekend call obligations

• Enjoy significant clinical autonomy within a supportive, collaborative environment

Qualifications

• MD or DO in Internal Medicine or Family Medicine

• Board certified or board eligible

• Preference for candidates with outpatient experience in high-need environments, such as health centers or home care

• Interest in population health and health equity

• Proven ability to work effectively in collaborative care settings

• Comfort with independent practice across varied care environments

• Eligible for Massachusetts medical license and DEA