WELLBE INTRODUCTION
The WellBe care model is a Physician Led, Advanced Practice Provider driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. WellBe's care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.
GENERAL SUMMARY
The Physician Assistant is responsible for modeling the WellBe values and mission in the care delivery for our patients. S/he is responsible for following the rules and regulations of state and federal regulatory agencies and any other certified agencies for their region. As an advanced practice provider at WellBe, you will play a vital role in the care for our patients in their home. This role is critical to our overall interdisciplinary team and focuses on providing compassionate care to the patients who have both chronic and acute illnesses and injuries while supporting their ability to stay in their own home. Our providers support a full patient panel and deliver longitudinal primary care, urgent care, and acute medical care to a wide variety of patients. This role delivers primarily home-based setting care for their patients. The Physician Assistant role is a key member of the team that will be accountable for the care of their patient panel, maintaining accurate, timely and current patient records. As part of our longitudinal model the Physician Assistant will support patients assuring, they are followed regularly with initial, urgent, transition of care and follow up appointments as needed to care for their health needs. The successful candidate works as part of our broader interdisciplinary team to assist in delivering concierge-style, timely and high-quality care to every patient.
Job DescriptionSKILLS & COMPETENCIES
Practices the WellBe mission: To help our patients lead healthier, meaningful lives by delivering the most CompleteCare™ to their patient panel.Will primarily support in- home, patient-facing visits to support patient care needs in the assigned market.Partners with other clinicians in the Care Community managing the health and wellbeing of patients in their home settings.Responsible for engaging attributed patients into WellBe program and supporting care needs and efforts to keep patients engaged.Facilitates staff, patient, and family decision-making by providing educational resources.Performs initial patient screenings/physical examinations, creates appropriate assessment/plan and completes documentation in a timely manner.Addresses urgent care needs of the patients as needed, including transition of care visits.Collaborates with community team to complete a full patient care assessment and plan.Orders, interprets, and analyzes diagnostic tests and determine the need for follow-up appointments and further treatment options per state supervisory agreement.Prescribes and manage medications and treatments as appropriate, including but not limited to psychopharmacological agents per state supervisory agreementUpdates patient records and verifies accuracy of records at each patient appointment.Delivers patient care and completes regular patient care reviews with supervising physician per state supervisory agreement.Delivers the highest standard of quality care while maintaining all standards pertaining to appropriate patient needs.Focuses clinical care delivery to support necessary items for documentation/coding, HEDIS measures, engagement of patients, and managing medical expenses.Serves as a key resource for patients in delivering ongoing care information, counseling, and guidance for any patients with chronic conditions.Utilizes all available resources to help care for patient needs and refers to internal/external resources as appropriate, such as WellBe behavioral health protocols.Collaborates with the interdisciplinary team and participate in regularly scheduled team meetings.Maintains required unencumbered, active state licensure(s) and national certification(s)Deliver palliative care, and when needed, support end of life care to patients and families.Facilitates family meetings with WellBe community team, to help with complicated family dynamics and goals of care.Adheres to a professional code of conduct in patient care delivery including completion of care needs and documentation standards.Oher tasks needed to accomplish team’s objectives/goals. Job RequirementsQUALIFICATIONS
Educational/ Experience Requirements:
Minimum Master’s Degree in Physician Assistant Studies (ARC-PA) from an accredited, entry-level PA program (required)3-5 years physician assistant experience required; new grads will not be considered.2-3 years of prior healthcare experience in areas such as medical assistant, certified nursing assistant, EMT/paramedic, clinical laboratory scientist registered nurse, or similar health care related roles (required)Active, unencumbered Physician Assistant license in the state of New York; state residency required.Current board certification in your field with NCCPA (National Commission on Certification of Physician Assistants) (required)BLS certified and an active NPI# as an PA (required)CPR certification (required)Active, unencumbered DEA licensure (required)Previous experience in home care, primary care, hospice, palliative care, or geriatrics strongly preferred, other complex patient health care experience also beneficial (preferred)Additional experience with telehealth care delivery (preferred)Have a valid driver’s license, automobile insurance, have access to an automobile; proof of in force automobile insurance required.Requires homes visits to patients in a variety of residential settings.Required Skills and Abilities:
Ability to conduct in- home setting visits and have previous experience on a telehealth platform.Demonstrated role proficiency with Microsoft Office; Excel, Word, G-suite, etc.Proficient with office software, including Electronic Health Records, Scheduling Software and Ring Central applications.Role model in courageous teamwork, integrity, ethics, and productivityExperience in diagnosing and treatment of ongoing, chronic, and urgent medical/psychological conditions of older adults.Experience in panel management, primary care, geriatrics, internal medicine, palliative careExperience in palliative care and end-of-life communicationExcellent verbal, written, presentation, and interpersonal communication skills.Confident speaker to internal and external groupsSupervisory Responsibility: This position will have supervisory responsibility.
Travel requirements: Travel may be required up to 100% locally to deliver patient care.
Work Conditions: Ability to lift up to 30 lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assisting with weights of more than 100lbs. Ability to stand for extended periods.
Ability to drive to patient locations (i.e., home, hospital, SNF, etc.). Fine motor skills/Visual acuity.
The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change, or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.
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