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Physician - House Calls - Providence RI (Physician #)

Company: Landmark Health
Location: Providence
Posted on: September 13, 2019

Job Description:

Landmark Health is a high growth, entrepreneurial, home-based provider team that is transforming healthcare by serving the extensive needs of the most chronically ill in our communities. Physicians lead a multidisciplinary team and serve on the frontlines delivering preventive and urgent medical care in the homes of complex, frail, and vulnerable patients. Through the integration of technology, a highly innovative care delivery model, and multidisciplinary clinical teams, Landmark delivers health management capabilities at scale for the frailest and most clinically complex segments of the population - the 3-5% of members that account for 20-30% of all national healthcare expenses annually. JOB DUTIES & RESPONSIBILITIES As a Physician, your duties will be to:

  • Function as day-to-day clinical leader, providing decision support to nurse practitioners and directing the multidisciplinary team
  • Perform 4-7 preventive visits daily to optimize chronic conditions, assess home environment, educate patients and caregivers, and develop proactive care plans
  • Perform urgent care visits in the home to avoid unnecessary ED transfers and hospital admissions
  • Leverage the support of nurse care manager, behavioral health, social work, pharmacy, and dietician to meet patients' medical, bio-psychosocial, and financial needs
  • In situations where there is no existing PCP for the patient, assume responsibility as PCP to drive care and continuity for patients
  • In situations where there is an existing PCP for the patient, help to co-manage the patient with the PCP and serve as an extension of clinical care into the home
  • Coordinate with other physicians across the continuum of care, including PCP, hospitalist, and SNF providers to smooth transitions and prevent re-admissions
  • Coordinate and offer medical direction to community-based organizations touching the lives of our patients, including housing and caregiver agencies, health plan contracted social work services, home health, adult day health centers, and behavioral health QUALIFICATIONS
    • Board Certified / Preferably Internal Medicine, Family Medicine, or Emergency Medicine
    • Doctor of Medicine M.D. or Doctor of Ostepathy D.O. from an accredited educational institution
    • DEA registration
    • Experience in Geriatrics
    • Experience managing complex, polychronic patients and comfort with high acuity
    • Dedication to transforming care for the sickest and frailest in a marginalized population
    • Eagerness to work with a diverse and multidisciplinary team Keyphrases: family medicine jobs, family practice jobs, family practitioner jobs, geriatric medicine jobs, geriatrician jobs, gerontologist jobs, family medicine specialist jobs

Keywords: Landmark Health, Providence , Physician - House Calls - Providence RI (Physician #), Healthcare , Providence, Rhode Island

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