This role involves providing comprehensive care for patients with multiple complex and chronic medical conditions, focusing on managing transitions across care settings and preventing hospital readmissions. The physician works collaboratively with a multidisciplinary team, practicing evidence-based medicine within a patient-centered medical home model. Responsibilities include treating acute exacerbations, coordinating care plans, and educating patients on chronic disease management and advanced directives.
Specific Duties and Responsibilities:
Complex Clinical Care:
Candidate Qualifications:
Preferred qualifications:
Working Conditions
This job operates in a professional office environment. This role routinely uses general office equipment. -OR- This job operates in a professional office environment. 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. Exposed to the diseases and infections of patients daily. May share workspace with other technicians and staff.
Physical requirements
family medicine physician, chronic disease management, transitional care, evidence-based medicine, multidisciplinary healthcare team, patient-centered medical home, complex clinical care, population health management, acute care treatment, electronic medical records
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