Physician Assistant

QUALIFICATIONS

• Medical Degree \& US license.
• Experiences in leading care coordination, or the equivalent in healthcare settings.
• Demonstrated skills in leadership, advocacy, communication, education, and counseling.
• Culturally effective capabilities demonstrating a sensitivity and responsiveness to varying cultural characteristics and beliefs.
• Bilingual (Chinese/Cantonese and English).

SKILLS/ABILITIES

• Ability to apply critical thinking skills and make sound judgments both while performing daily responsibilities.
• Knowledge of the case management process and the patient-centered medical home (PCMH).
• Knowledge and demonstrated abilities to work in a regulatory climate that includes oversight by federal and state rules, payer contracts, governmental benefits, and community resources.
• Effective oral and written communication skills.
• Excellent interpersonal skills reflecting clarity and diplomacy and the ability to communicate accurately and effectively with all levels of staff and management.
• Empathy, mental alertness, precision, analytical problem-solving abilities, communication skills, focus, and initiative.
• Knowledge of EHR (MDLand).

RESPONSIBILITIES

• Apply the principles of comprehensive, community-based, patient-centered, developmentally appropriate, and culturally and linguistically appropriate care coordination.
• Use case management processes to assure quality care is delivered to the practice’s patients, the patients’ families, and the patients’ caregivers in the most efficient and effective manner across the healthcare continuum.
• Engage patients, patients’ families, and their caregivers in understanding, setting, and monitoring patient self-management care plans in a manner that is culturally and linguistically appropriate to the patient and caregiver.
• Complete health risk assessments as a foundation for developing individualized care plans and outcomes goals for patients and their families.
• Document each patient’s individualized care plan and care coordination in the practice’s database.
• Coordinate the patient’s care by facilitating patient, family, or other caregiver access to medical home providers, staff, and resources as needed by the patient.
• Conduct and document assessments of patient needs and resources for effective self-care management.
• Act as the primary contact point, advocate, and source of information for patients and the community partners who help treat them.
• Research, find, and link patients to resources, services, and support mechanisms for their care plans and self-care management needs.
• Provide timely communication with patients, make inquiries, execute follow-up actions, and help to integrate information into the care plan.
• Assist the care team by helping to measure quality and identify, refine, and implement performance improvements that support the medical home.
• Assist the care team in performance evaluation and quality improvement.
• Continually monitor the cost effectiveness of services provided through the patient’s individualized care plans, and recommend any needed changes to those plans based on evidence-based, clinical guidelines from sources identified by the practice.
• Participate in continuing professional growth through attendance at workshops and professional in-services and through individual research and reading, to include communication skills.
• Participate in population management activities as directed by the practice.
• Demonstrate personal responsibility and respect for patients, patients’ families, and co-workers in professional appearance.
• Demonstrate flexibility, enthusiasm, and willingness to cooperate while working with others in multi-disciplinary teams with activities to include participating in daily huddles.

Benefits:

• 401(k)
• Health insurance

Work Location: In - person