- Provide care for people living with HIV and associated medical conditions and patients with other chronic infectious diseases.
- Provide outpatient care consultation and ongoing treatment of chronic infectious diseases.
- Deliver comprehensive care for patient panel, including management of chronic diseases directly or through collaboration with primary care physicians and specialist.
- Work in a team environment (with social work, care management, integrated behavioral health, pharmacy, nutrition, health education etc.), process feedback, and facilitate open discussion.
- Implement plans of care in collaboration with the patient, their family and other team members.
- Develop strong transitional care plans and able to keep track of paneled patients along the whole continuum of care including hospital discharges, ER, skilled nursing facilities and home care.
- Vigilant in keeping track of patients and their disease processes to avoid ER visits, admissions to the hospital and readmissions.
- Assist with educating patients regarding their chronic diseases and healthy choices.
- Assist with the education and discussion of chronic disease progress and advanced directives.
- Practice evidenced based medicine in accordance with the PCMH model of care.
- Assessment, planning and coordination of care for HIV/AIDS patients.
- 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.
- 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.
- This job description is subject to change at any time.
- Unrestricted Maryland Medical License
- Board certified Internal Medicine or Family Practice
- Certified by AAHIVM OR
- Board Certification in Infectious Diseases.
- BLS
- DEA
- Experience in population health management is preferred.
- Experience in working with psychosocially and medically complex patients is strongly preferred.
- Knowledge or experience with NCQA PCMH model is preferred.
- Must be able to work as part of a multidisciplinary team with constant collaboration within and across provider teams.
- Innovative and creative and innovative self-starter to help solve patient's problems.
- Experience and comfort around maximizing EMR systems.
- Excellent interpersonal and communications skills.
- Effectively adapt and respond to a complex, fast-paced, and results-oriented environment.
- Knowledge and experience using Electronic Medical Records and ability to analyze and leverage their reporting capabilities.
- Working knowledge of Microsoft Office Suite (Word, Outlook, PowerPoint, and Excel).
- Job may be physically demanding at times.
- Remain stationary for extended periods of time.
- Repetitious movements.
- Frequently move equipment or supplies weighing up to 20 lbs.
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Description
1394
Remote?: 0
Highlights (Bonus, shift, relocation, info for job):
Position Summary
This role provides physician services to include patient consultation, primary management of people living with HIV and other chronic infectious diseases. These services include developing a diagnostic and treatment care plan, counseling patients regarding the most appropriate setting to meet their healthcare needs, educating them about their illnesses, advising appropriate specialist services, and end of life programs. The role functions as a part of a large, integrated care team with the goal of providing whole-person care in the outpatient setting.
Duties and Responsibilities
This job operates in a patient care setting where there is potential exposure to blood, bodily fluids, and infectious materials. This role routinely uses general office equipment. Often wear a special uniform, such as a lab coat or surgical scrubs, protective or safety attire, such as gloves and masks.
At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer.
We call this "care beyond medicine." We have turned the doctor's office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members' needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.
We don't stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works.
Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT2.
AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.
EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.
