Employer Active
Not Disclosed
Salary Not Disclosed
1 Vacancy
Manage a panel of patients to improve their health through longitudinal primary care care management and care coordination in the home setting and virtual care.
Conduct patient assessments physical exams and care management in the home setting.
Perform acute medical health visits and/or telephone calls for members on your panel to ensure that timely and appropriate medical care to avoid emergency department visit or hospitalization.
Perform postdischarge visits for your panel within 4872 hours of discharge from a facility to decrease risk of readmission; perform detailed medication reconciliation and assure that appropriate longterm services are in place.
Order administer obtain and record diagnostic tests (blood tests Xrays etc.).
Diagnose health conditions and illnesses assess cases presented to you by your care team and utilize your clinical competencies to prioritize patient needs.
Propose treatments for chronic and infectious diseases prescribe and reconcile appropriate medications and educate patients about their conditions and medications.
Maintain update and escalate accurate case notes concerns and reports monitoring clinical quality gaps in care in consultation with the care team.
Educate patients their family members and nonclinical staff on preventive care and wellness.
Utilize electronic health record and care management tools to collect data document member interactions in the field organize information track tasks and communicate with your team members and community resources.
Attend team meetings and case conferences to advise on physical health needs and establish health goals.
Full Time