Physician; Primary Care Value- Care​/PACE Model

Position: Physician (Primary Care Value-Based Care / PACE Model)

Under the supervision of the Medical Director, provides primary medical care to assigned Community Care Program members, including assessment, development of a plan of care in collaboration with the interdisciplinary team, provision of direct medical care and evaluation of effectiveness of the plan of care. The Physician functions in a collegial relationship with the other health professionals, making in- dependent decisions regarding medical needs and health regimens, and carries out medical procedures as indicated.

The quality of the medical care is under the direction of the CMO and Medical Director.

Organizational Responsibilities Title and Description Member Experience

Achieves member outcomes and goals through adherence to standards of care and best practices.

Interacts with members and their families with the highest level of respect, compassion and integrity.

Identifies and/or participates in efforts to continuously improve the quality of member care and services.

Fosters our member-centered culture on a daily basis.

Employees

Participates in efforts to enhance work experiences.

Actively seeks and participates in training and development opportunities.

Provides honest feedback and ideas to help CCI become a more competitive employer.

Participates in team, department, and site activities, as appropriate.

Operations

Supports the achievement of operational goals by adhering to operational standards, and complying with contractual, regulatory, and CCI policy requirements and expectations.

Identifies and elevates ideas for operational improvement.

Finances

Identifies, delivers and/or coordinates and monitors member care/services that consider member needs, outcomes and cost.

Supports a culture of effective cost management. Identifies and elevates cost-improvement opportunities.

Supports new business development, as needed.

Job Specific Responsibilities Title and Definition Health History and Findings

Obtains a complete health history and records findings, and maintains documentation of health care services.

Physical Exams and Care Planning

Performs physical examinations, functional status evaluation and/or mental status evaluations as indicated. Treats acute and chronic conditions based on member history, clinical assessment, laboratory and diagnostic testing, and member preferences and goals of care.

Preventative Care

Provides preventive health care, episodic care and health promotion for members, and arranges referrals as indicated.

Exercises clinical judgment when evaluating members for disease process, orders appropriate and clinically indicated testing, reviews and/or interprets screenings and selected diagnostic tests. Discriminates between normal and abnormal findings associated with aging, pathological processes, lifestyles, and/or family relationships as influenced by chronic illness. Develops plan for follow up based on results, which may include consultation.

Behavioral Health Evaluation

Identifies and describes behavioral patterns of the developmentally disabled, physically disabled and aged chronically ill and integrates developmental processes, life style and family relationships.

Supervision

Works as supervising physician with the nurse practitioner or clinical nurse specialist at designated site.

Triage and Follow-up

Triages status changes and facilitates appropriate management of problems. Treats and manages members' acute chronic illnesses.

Prescriptive

Regulates and adjusts medications as needed.

Documentation

Maintains documentation of provided, coordinated and contracted health care services.

Member/Caregiver Education

Educates members and families regarding health maintenance and acute and chronic illnesses.

Functions as a member of the interdisciplinary team and participates in the development of the comprehensive plan of care and ongoing monitoring of members health status, providing geriatric and medical knowledge when needed. Provides leadership to the team in utilizing appropriate resources to gather information and guide decisions. Assists the team in creative care planning for challenging cases.

Employee Orientation

Assists in the orientation and training of new employees.

Performs other related duties as assigned.

Core Competencies Title and Description Interpersonal skills

Establishes and maintains positive working relationships; practices attentive and active listening; gains trust and support of coworkers; expresses ideas appropriately; can manage diverse relationships.

Mission-centered

Demonstrates commitment to CCI's…