Job Description
Job Description
Job description
We are seeking a mission-driven Telehealth Primary Care Physician to provide remote medical consultations and ongoing clinical support for patients across post-acute, long-term care, and complex care settings. This role focuses on proactive chronic disease management, timely intervention, care coordination, and reducing avoidable hospitalizations and readmissions.
Responsibilities
- Provide remote patient consultations and follow-up care via telehealth
- Evaluate patients, develop treatment plans, and ensure timely clinical follow-up
- Perform Transitional Care Management (TCM), including post-discharge follow-up, medication reconciliation, and coordination of care
- Manage chronic and complex medical conditions through evidence-based virtual care
- Collaborate with NPs/APPs, nursing staff, care coordinators, rehabilitation teams, and other providers
- Respond promptly to changes in patient condition and help prevent avoidable hospital transfers and readmissions
- Participate in interdisciplinary care planning and case review
- Discuss goals of care, preventive care, and palliative care options with patients and families as appropriate
- Maintain accurate, timely documentation in the EMR
- Support continuity of care through strong communication with patients, families, and clinical teams
Qualifications
- MD or DO from an accredited medical school
- Board Certified or Board Eligible in Internal Medicine, Family Medicine, or Geriatrics
- Active, unrestricted medical license in [State] or eligibility to obtain
- Current DEA registration, as applicable
- Experience with telehealth/virtual care
- Familiarity with or experience in Transitional Care Management (TCM) required
- Experience in primary care, geriatrics, post-acute care, long-term care, or complex care management preferred
- Proficiency with EMR systems and telehealth platforms
- Strong communication, clinical decision-making, and care coordination skills
Preferred qualifications
- Experience managing medically complex adult or geriatric patients
- Experience working with interdisciplinary care teams
- Comfort discussing goals of care and advanced care planning
- Strong documentation and organizational skills
Ideal candidate
- Patient-centered and compassionate
- Confident making clinical decisions in a remote care environment
- Proactive, responsive, and detail-oriented
- Comfortable collaborating with both remote and on-site care teams
- Committed to improving outcomes and supporting care transitions